Looking for a job

Shavon User

@shavonuser

Message

I resolve complex Medicare enrollment, eligibility, claims, and coverage issues.

United States

Message

What I'm looking for

I'm looking for healthcare operations work where I can investigate complex Medicare or health plan cases, apply CMS and HIPAA requirements, coordinate across teams, and improve accurate, compliant member outcomes.

I've supported Medicare, Medicaid, and health plan operations at eHealth, Carrington Insurance, Bloom Insurance, Sentara Health Plans, and Anthem HealthKeepers. I research eligibility, enrollment, coverage, billing, benefits, provider access, and claims issues to move complex member cases toward accurate resolution.

I apply CMS requirements, carrier guidelines, and HIPAA standards while maintaining audit-ready documentation and coordinating across claims, provider, clinical, and operational teams. I'm strongest in case investigation, root-cause analysis, compliant escalation, and improving the consistency of healthcare operations.

Experience

Work history, roles, and key accomplishments

Current

Medicare Supplement & Ancillary Advisor

Current

eHealth

Jun 2026 - Present (2 months)

Apply carrier underwriting guidelines through health screenings and eligibility review to support compliant Medicare Supplement enrollment decisions. Research policy provisions and coordinate with internal teams to resolve application discrepancies.

Regulatory Compliance Underwriting Guideline Knowledge Eligibility Assessment Payment Processing HIPAA compliance Case Investigation

Current

Medicare Operations 1099 Independent

Current

Carrington Insurance

Mar 2023 - Present (3 years 5 months)

Investigate Medicare eligibility, enrollment, coverage, and benefit discrepancies by reviewing CMS requirements, member records, and carrier information to identify root causes.
Research coordination-of-benefits issues and coverage conflicts to support accurate next steps and reduce downstream enrollment or access problems.

Coordination Of Benefits Eligibility Verification Medicare Guidelines Medicare Advantage Regulatory Compliance

Senior Medicare Enrollment Specialist

Bloom insurance

Jan 2024 - Oct 2024 (9 months)

● Reviewed Medicare enrollment applications for accuracy, completeness, eligibility, and CMS compliance, researching discrepancies before submission or resolution.
● Investigated enrollment, billing, and coverage issues using member information, carrier requirements, and regulatory guidance to determine appropriate next steps.

Root Cause Analysis Process Improvement Benefits Administration Medicaid

Education

Degrees, certifications, and relevant coursework

University of Phoenix

Undergraduate Certificate, Information Assurance & Security

2026 -

Grade: A

Activities and societies: Hands-on labs in Cisco Packet Tracer, Cisco IOS/CLI, IPv4 addressing, routing fundamentals, PuTTY, and Linux/Ubuntu.

Pursuing an Undergraduate Certificate in Information Assurance & Security, with coursework in networking and information systems fundamentals.

Tidewater Community College

Associate , Human Services

2019 - 2023

Grade: B

Relevant Coursework: Human Services, Case Management, Counseling, Psychology, Sociology
Applied Skills: Client Advocacy, Needs Assessment, Resource Coordination, Case Documentation, Crisis Support, Community Referrals