Shanna Savone
@shannasavone
I resolve Medicare and Medi-Cal appeals, grievances, and complex member cases.
United StatesWhat I'm looking for
I've supported Medicare and Medi-Cal operations across appeals, grievances, claims research, and member services for 10 years. In my current contract role supporting Kaiser Permanente, I maintain 99% accuracy across at least 50 appeal and grievance case files each month while meeting mandated timeframes.
At Angle Health, I investigated complex provider appeals and administrative complaints, prepared monthly regulatory reports, and participated in oversight audits, IRR reviews, and focused audits. I also identified process improvement opportunities from case trends and audit findings.
At L.A. Care Health Plan, I helped members understand benefits, eligibility, coverage determinations, and claim status while researching payment and processing errors. Earlier at UnitedHealth Group, I entered and routed clinical cases in Facets, maintained 95% data-entry accuracy, and achieved 100% accuracy in letter generation within compliance timeframes.
I'm known for investigative thoroughness, accurate documentation, regulatory turnaround-time compliance, and audit readiness.
Experience
Work history, roles, and key accomplishments
Case Coordinator, Appeals and Grievances
Rose International
Jul 2024 - Present (2 years 1 month)
Maintain a 99% accuracy rate across a minimum of 50 appeal and grievance case files per month while meeting mandated performance timeframes. Review and triage incoming cases for assignment to the Case Manager, resolving complex and sensitive member issues.
Appeals and Grievances Specialist
Medix
Oct 2023 - Feb 2024 (4 months)
Identified, investigated, and resolved administrative complaints and complex provider appeals. Received, acknowledged, and prepared case files, routing complaints to the appropriate internal department for investigation and resolution.
Medicare and Medi-Cal Customer Service Representative
L.A. Care Health Plan
Apr 2019 - Mar 2023 (3 years 11 months)
Supported Medicare and Medi-Cal members on benefits, eligibility, coverage determinations, and claim status for a Medi-Cal managed care health plan. Received and documented grievance and appeal intake, routing cases to the appropriate department for investigation and resolution within regulatory timeframes.
Initiated cases by entering clinical information into the Facets system from telephone, fax, and electronic sources, and routed cases to nurses for clinical review and decision. Maintained a minimum of 95% case data entry accuracy and 100% accuracy in letter generation within compliance timeframes.
Education
Degrees, certifications, and relevant coursework
Capella University
Bachelor of Science, Healthcare Administration
Pursuing a Bachelor of Science in Healthcare Administration Leadership, expected completion in September 2026.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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