Shanita Burnside has over 15 years of experience in claims and customer service. She is currently a Prior Authorization Rep at Superior Vision where she manages claims examiners and processes new insurance policies. Previously, she was a Full Service Representative at Carefirst BCBS, combining customer service and claims work. She has strong communication, organization, and problem solving skills.

1. SHANITA BURNSIDE
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2 Triple Crown Court
Windsor Mill, MD 21244
(443)527-0989
nita5622@gmail.com
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Energetic professional with a solid history of in claims and service. Motivated leader with strong
organizational and prioritization abilities. Areas of expertise include problem-solving,
organization and customer satisfaction. Service-oriented Customer Service Rep with a 15-year
background in Claims/Service at BCBS. Excellent communication and time management skills.
Handles tasks with accuracy and efficiency and would be a great asset to your team.
Skills
• Microsoft Word and Excel
• PowerPoint and Access
• Time Management
• Judgment and Decision Making
• Claims Processing
• Clerical
• Service Orientation
• Complex Problem Solving
Experience
Prior Authorization Rep, 06/01/2016-Present
Superior Vision- Linthicum, MD
 Work ina highvolume claimsenvironmentincludingdailyManagementof varioustypesof
claims.
 Manager of the ClaimsExaminersthatwill be responsibleforreviewingcorrectingand releasing
claimsforpayment.
 Some additional dutiesperformedincludeprocessingnew insurance policies,modifyingexisting
onesand obtaininginformationfrompolicyholderstoverifythe accuracyof theiraccounts.

2. Full Service Representative, 12/2014 to Present
Care first BCBS – Owings Mills, MD
 This positions combines customer service representative with claims representative
 Confer with customers by telephone to provide information about benefits or services
included in their contracts
 Keep records of customer calls and claims, recording details of inquiries, complaints, or
comments, as well as actions taken when necessary.
 Check to ensure that appropriate changes are made to resolve customers' issues.
 Contact customers to respond to inquiries or to notify them of claim investigation results
or any planned adjustments.
 Refer unresolved customer grievances to designated departments for further
investigation.
 Review claims for dental providers, examining them for accuracy and necessity
 approving or disapproving claims.
Claims Examiner II, 10/2000 to 12/2014
Carefirst BCBS – Owings Mills, MD
 Review financial statements, sales and activity reports, and other performance data to
measure productivity and goal achievement and to determine areas needing cost
reduction and program
 Calculate amount of claims.
 Pay small claims.
 Transmit claims for payment or further investigation.
Education
University of Maryland University College, Aldelphi, MD
Bachelor of Science in Business Management –Accounting-Minor
GPA: 3.25 Expected completion, June 2017
High School Diploma: Arts and Humanities, Jun 1996
Patterson High School - Baltimore, MD
References available upon request