Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shantanie Applewhite

Bassfield

Summary

Experienced Advanced Care Specialist that is detail-oriented and results-driven. Extensive experience in managing high-volume customer interactions and providing exceptional care in fast-paced environments. Adept at processing insurance claims, verifying patient information, and navigating complex healthcare systems, including medical billing, coding (ICD-10, CPT, HCPCS), and claims denial management. Skilled in ensuring compliance with HIPAA regulations and healthcare industry standards, while delivering accurate and timely solutions. Proven track record of successfully de-escalating challenging situations, advocating for patient needs, and collaborating with insurance providers to resolve issues efficiently. Strong technical skills in claims management software and EHR systems, with a commitment to maximizing claims accuracy and optimizing patient outcomes. Ready to contribute exceptional customer service, problem-solving abilities, and healthcare claims expertise to drive the success of a Health Claims Specialist team.

Overview

8
8
years of professional experience

Work History

FOSC Inbound Residential Specialist

ADT Security
11.2021 - Current

· Coordinated and scheduled on-site visits for system installations, repairs, and routine maintenance based on customer availability and technician schedules.

· Managed reschedules and cancellations promptly, offering alternative appointment times to ensure customer satisfaction.

· Updated and maintained accurate customer and service records in scheduling systems. Ensured that all service calls are completed within the designated time frame to meet company standards.

Customer Service Representative

Wayfair
02.2021 - 11.2021

· Responded to customer inquiries via phone, email, and chat regarding product details, order status, and delivery information.

· Managed and de-escalated customer complaints professionally, ensuring that customer concerns are addressed with empathy and efficiency.

· Resolved account-related issues, such as billing discrepancies, order status, and delivery problems.

Operative Technician

Praxair Technology
08.2018 - 03.2020

· Performed routine inspections, preventative maintenance, and troubleshooting of machinery to ensure compliance with safety and operational standards.

· Maintained accurate and up-to-date records of system operations, maintenance, and repairs, ensuring full compliance with industry regulations.

· Worked closely with engineering, operations, and safety teams to address technical issues, improve system performance, and enhance operational efficiency.

Foreman/QA

Marshall Durbin
11.2016 - 01.2018

· Managed a team of QA technicians, providing guidance, training, and performance evaluations to ensure high-quality product standards.

· Conducted routine inspections of production lines, including raw materials, in-process products, and finished goods, ensuring adherence to safety, quality, and food safety standards.

· Ensured compliance with USDA, FDA, and other regulatory agencies’ guidelines for food safety and quality.

Education

Associate of Arts - Health Information Management

Jones Community College
Ellisville, MS
05-2025

No Degree -

William Carey University
Hattiesburg, MS
01.2012

High School Diploma -

Bassfield High School
Bassfield, MS
01.2010

Skills

  • HIPAA Compliance
  • Insurance Verification
  • Claim Denial Management
  • Third-Party Billing
  • Patient Advocacy
  • Experience in Trizetto, Epic, Cerner
  • Experienced in Excel, Word, PowerPoint
  • Attention to Detail
  • Regulatory Compliance
  • Risk Management
  • Insurance Regulations
  • State & Federal Healthcare Laws

Timeline

FOSC Inbound Residential Specialist

ADT Security
11.2021 - Current

Customer Service Representative

Wayfair
02.2021 - 11.2021

Operative Technician

Praxair Technology
08.2018 - 03.2020

Foreman/QA

Marshall Durbin
11.2016 - 01.2018

Associate of Arts - Health Information Management

Jones Community College

No Degree -

William Carey University

High School Diploma -

Bassfield High School
Shantanie Applewhite