Shante Adams
Terrytown
Summary
Professional with extensive background in healthcare administration. Skilled in managing prior authorization processes, claims processing, ensuring compliance, and improving efficiency. Strong focus on team collaboration and achieving results, adaptable to changing needs. Reliable, organized, and proficient in navigating complex healthcare systems with excellent communication and problem-solving skills.
Professional advocate well-versed in service delivery and client support. Adept at resolving complex issues, ensuring client satisfaction, and enhancing service quality. Strong focus on teamwork and adaptability, with proven track record of achieving impactful results. Known for excellent communication, problem-solving abilities, and client-centered approach.
Overview
5
5
years of professional experience
Work History
Service Advocate
Aetna
08.2025 - Current
- Resolved customer inquiries efficiently, ensuring timely and accurate information delivery.
- Enhanced service processes by identifying and implementing improvements based on client feedback.
- Collaborated with cross-functional teams to streamline operations and improve service quality.
- Trained new staff on procedures and best practices to enhance team performance and customer satisfaction.
- Facilitated communication between departments to resolve complex issues impacting customer experience.
Prior Authorization Specialist
Lcmc Health
07.2024 - 08.2025
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Collaborated with healthcare providers to gather necessary documentation for authorization approvals.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reviewed and processed prior authorization requests for medical services to ensure compliance with insurance guidelines.
Medical Claims Processor
HUMANA
05.2023 - 07.2024
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Researched and resolved complex medical claims issues to support timely processing.
- Processed and reviewed medical claims for accuracy and compliance with regulatory standards.
- Collaborated with healthcare providers to resolve discrepancies and ensure timely claim payments.
Clinical Case Manager
Tulane Hospital & Clinic
07.2021 - 05.2023
- Enhanced care coordination for patients with complex medical needs through effective communication and collaboration with multidisciplinary teams.
- Reduced hospital readmission rates by conducting thorough patient assessments and providing appropriate resources and support for post-discharge care.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
Education
Master of Arts - Health Informatics And Analytics
University of Arizona
Tucson, AZ05-2026
Masters of Arts - Health Care Administration
University of Arizona Global Campus
Tucson, AZ10.2024
Bachelor of Arts - Health Care Administration
University of Arizona Global
Tucson, AZ05.2023
Associate of Science - Medical Billing And Coding
Ultimate Medical Academy
Clearwater, FL06-2020
High School Diploma - undefined
John Ehert High School
Marrero05.2011
Skills
- Customer service background
- Decision-making skills
- Complex Problem-solving
- Complaint handling
- Time management
- Attention to detail
Timeline
Service Advocate
Aetna
08.2025 - Current
Prior Authorization Specialist
Lcmc Health
07.2024 - 08.2025
Medical Claims Processor
HUMANA
05.2023 - 07.2024
Clinical Case Manager
Tulane Hospital & Clinic
07.2021 - 05.2023
High School Diploma - undefined
John Ehert High School
Master of Arts - Health Informatics And Analytics
University of Arizona
Masters of Arts - Health Care Administration
University of Arizona Global Campus
Bachelor of Arts - Health Care Administration
University of Arizona Global
Associate of Science - Medical Billing And Coding
Ultimate Medical Academy