Shontay Cole

At Centene, I manage Medicare, Medicaid, Medi-Cal, AIP, C-SNP, and D-SNP member grievances and appeals. I research cases, document outcomes, and coordinate timely resolutions aligned with CMS regulations and organizational policies.

I've supported care coordination through Centene's Department of Defense TRICARE Prescription Monitoring Program, helping members access appropriate services, medications, and provider support. My work includes patient records, authorizations, scheduling, insurance verification, and confidential communication.

Across StateServ Medical, Preferred Homecare, and HonorHealth, I've handled DME intake, billing, coding, claims, referrals, and complex insurance benefits. I bring practical experience navigating payer requirements while helping patients, providers, and health plans move care forward.