Shanequa J Knight is a skilled professional, that works in Amerihealth Nj on the position of Appeals Specialist from 2015. Shanequa has earned professional experience in more than 19 positions at different companies. Shanequa J Knight went to the Kean University and received education there from 2008. Roselle, New Jersey is the city, where this person was lastly known to be living. Shanequa's phone number and email are accessed through SoftwareOfficial on demand.
Name variants:
Shanequa Knight
Last updated Jun 19, 2024
Contact Information
Last Update
Jul 3, 2022
Email
kn**@yahoo.com, sh**@gmail.com
Location
Roselle, NJ
Company
Amerihealth Nj
Workplace
Appeals Specialist
Work History
Appeals Specialist
Prepare case files for administrative and medical review that are organized, contain relevant documentation and are processed within the required timeframes.
Communicate with members and/o...
from Mar 2015
Project Coordinator
1900 Market St SUITE 500, Philadelphia, PA 19103
Manage spreadsheet of all reported end user Aerial issues for senior management discussion with Medecision to address possible defects and enhancements.
Initiate the resolution of Aerial i...
Oct 2014 — Mar 2015
Appeals and Grievance Specialist
Prepared member and provider appeal files for decision determination.
Generated calls to members and providers regarding the status of their appeal.
Entered appeals and grievances in inte...
Sep 2014 — Oct 2014
Compliance Auditor
3 Penn Plz, East Newark, NJ
Conducted an audit of 372 member and provider claims on a quarterly basis against State and Federal regulations to ensure compliance.
Facilitated the development and monitoring of correcti...
Apr 2010 — Jan 2014
Compliance Administrator
3 Penn Plz, East Newark, NJ
Apprised management of compliance issues as they arose to determine risk level and the need for possible audit.
Investigated and researched possible compliance violations as a result of in...
Sep 2008 — Apr 2010
Executive and Regulatory Appeals Analyst
3 Penn Plz, East Newark, NJ
Generated 3-4 written pieces of correspondence weekly to regulatory agencies in response to member and provider appeals detailing appeal resolution. Organized and analyzed on a daily basis d...
Apr 2007 — Sep 2008
EXECUTIVE & REGULATORY APPEALS ANALYST
Newark, NJ
2007 — 2008
Pharmacy Utilization Specialist
3 Penn Plz, East Newark, NJ
Gathered clinical and member benefit data to coordinate and prepare member and provider pharmacy appeals.
Entered approved and denied authorizations in AS/400 system for proper adjudicatio...
Nov 2005 — Apr 2007
PEND SPECIALIST, HORIZON BCBS OF NJ
Newark, NJ
2002 — 2005
Customer Service Representative
3 Penn Plz, East Newark, NJ
Finalized 60 HMO and Medicare Part C claims, adjustments and pends on a daily basis in accordance with Plan policies, procedures and contract provisions.
Determined the appropriate course ...
Mar 1999 — Nov 2005
Newark, NJ
1999 — 2014
Compliance Auditor Ii
Facilitate the development and monitoring of corrective action plans to address areas of non-compliance.
Maintain documentation to identify any open or closed Service Division issues.
Doc...
Executive and Regulatory Appeals Analyst
Generated 3-4 written pieces of correspondence weekly to regulatory agencies in response to member and provider appeals.
Organized and analyzed on a daily basis data from various internal ...
Education
2006 — 2008
2004 — 2006
Occupations
Coordinator
Guide
IT Professional
IT Analyst
Information Systems Analyst
Executive
Chief Administrative Officer
Managers
Tour Guide
Chief Executive
Skills
Letters
Regulations
Provider Relations
Compliance Training
Art
Jersey
Corrective Actions
Workflow
Human Resources
Employee Benefits
Yahoo
Executive Management
Medicaid
Insurance
Rights
Vendors
Site Visits
Account Management
Compliance Monitoring
Medicare
Hipaa
Detail Oriented Problem Solver
Reviews
Legal Writing
Prior Authorizations
Business Services
Business Analysis
Trade Unions
Resolve Issues
Software Documentation
Adjustments
Federal Regulations
Healthcare
Utilization
Vendor Management
Process Improvement
Claim
County
Compliance
Medicine
Case Management
Hmo
Goal Oriented Individual With Strong Leadership Capabilities
Complaints
Policy
Managed Care
Provider Networks
Customer Service
Horizon
Regulatory Agencies
Contractual Agreements
Management
Measurements
Documentation
Prior Authorization
Pharmacy
Appeals
Science
System Monitoring
Public Administration
Reporting
Health Insurance
Lessons Learned
Investigation
Eligibility
Evaluation
Presentations
Analysis
Written
Coordinated
Coordinate
Access
Resolve
Internal Audit
FAQs about Shanequa J Knight
What is the main profession of Shanequa J Knight?
This professional's job is Appeals Specialist
What jobs is Shanequa a professional at?
The expert is proficient at Coordinator jobs.
Where is Shanequa J Knight currently located?
The expert is located in Roselle, New Jersey.
Does the expert have the email address?
kn**@yahoo.com and sh**@gmail.com is Shanequa J Knight's email address.
Where did Shanequa J Knight work?
The professional worked at Amerihealth Nj, Amerihealth Administrators.
Where has Shanequa J Knight studied?
Shanequa studied at the Kean University from 2008.
What are professional skills of Shanequa J Knight?
This person has such skills as Letters, Regulations, Provider Relations, Compliance Training, Art, Jersey, Corrective Actions, Workflow, Human Resources, Employee Benefits, and Yahoo.