sharelle watson

I am a Provider Services Advocate with experience adjudicating claims and supporting providers under HMO, PPO, Medicare, and Medicaid plans. I leverage deep knowledge of claims systems and contractual guidelines to ensure accurate, timely resolutions.

In my current role at AmeriHealth Caritas NC, I review and adjudicate claims, suspend and route claims requiring special handling, and act as a Subject Matter Expert providing training and participating in user acceptance testing. I routinely create work orders and collaborate with support and external departments to resolve provider issues.

Previously, I worked in customer-facing roles across healthcare and utilities — including UnitedHealth Group, EmblemHealth, Spectrum, and the University of Mississippi — where I handled appeals, billing inquiries, ICD-10 related communications, and high volumes of calls, chats, and emails. I bring strong troubleshooting, documentation, and audit-reconciliation skills.

I am passionate about delivering professional, timely service to providers and members, improving processes to reduce reoccurrence of errors, and using system knowledge to train teams and support quality outcomes.