Shamica Auguste
Davenport
Summary
Professional with experience in facilitating access and support services. Known for strong collaborative skills and ability to adapt to changing needs, ensuring reliable and effective outcomes. Skilled in communication, problem-solving, and customer service. Valued for integrity, dependability, and results-driven mindset.
Overview
3
3
years of professional experience
Work History
Consumer Access Specialist
AdventHealth
08.2024 - Current
- Minimizes duplication of medical records by using problem-solving skills to verify patient identity through demographic details
- Creates accurate estimates to maximize up-front cash collections and adds collections documentation where required
- Calculates patients’ co-pays, deductibles, and co-insurance
- Provides personalized estimates of patient financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services
Medical Receptionist
Celebration OBGYN
06.2023 - Current
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
- Managed multi-line phone system and pleasantly greeted patients.
- Provided compassionate customer service, creating a welcoming atmosphere for patients and their families.
- Maintained current and accurate medical records for patients.
- Enhanced patient satisfaction by efficiently managing the front desk operations and addressing inquiries in a timely manner.
- Streamlined appointment scheduling for improved patient flow and reduced wait times.
Associate VB Claims Specialist
Unum
02.2022 - 04.2023
- Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and referrals/notifications to other areas (i.e., medical assessments, billing, etc.) as appropriate
- Proofs claim or referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis and pre-coding requirements
Education
High School Diploma - undefined
01.2004
Skills
- Medical Terminology
- Medical Records
- Data Verification
- Microsoft Office Expertise
- Release of Information
- Data Input
- EMR (Epic, Athena Health)
- Claim investigation
- Document workflow
- Claims review
- Claims trend analysis
- Claims history analysis
- Claims processing
- Critical thinking
- Computer skills
- Records review
- Decision-making
- Coverage determination
- Healthcare common procedures coding system (HCPCS)
- Claims evaluation
Timeline
Consumer Access Specialist
AdventHealth
08.2024 - Current
Medical Receptionist
Celebration OBGYN
06.2023 - Current
Associate VB Claims Specialist
Unum
02.2022 - 04.2023
High School Diploma - undefined
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