Nequisha Hawkins
Summary
Medical claim Specialist with broad knowledge in healthcare, life and property insurance domains. Experience includes policy analysis, claims management, and customer service. Strengths include strong analytical skills, adept at multitasking and effective communication capabilities.
Overview
12
12
years of professional experience
1
1
year of post-secondary education
Work History
Claims Specialist IIl
PFS
Houston
09.2022 - Current
- Identified incorrect charges on invoices by comparing them against contracts and fee schedules.
- Maintained accurate records of all claim activities for audit purposes.
- Verified patient eligibility for medical claims and determined benefit coverage.
- Reviewed denials, rejections, and underpayments from insurance carriers.
- Processed appeals on rejected or partially paid claims, including filing additional paperwork as needed.
- Resolved issues related to denied or underpaid claims in a timely manner.
Billing Specialist
Arthritis Knee Pain Centers
The Woodlands, TX
12.2020 - 09.2022
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Investigated and resolved issues to maintain billing accuracy.
- Developed database systems to track billing and adjust claims.
- Processed refunds on credit balances to maintain positive account relationships.
- Ensured compliance with all safety regulations in the workplace.
- Provided coaching and feedback on employee performance, encouraging professional development.
- Established clear expectations for employees, providing guidance when needed.
Medical Administrative Assistant
R and R Rehabilitation
Houston, TX
03.2014 - 11.2019
- Interviewed patients to collect medical information and insurance details.
- Prepared and sent financial statements to support bookkeeping functions.
- Compiled physical and digital paperwork to meet business and patient needs, including charts, reports and correspondence.
- Supported administrative and healthcare staff with skilled clerical assistance such as ordering supplies and organizing office inventories.
- Confirmed patient information, collected copays and verified insurance.
- Reached out to patients day before scheduled appointments to confirm times and instructions.
- Managed physician calendar, including scheduling patient appointments and procedures.
Education
Associate of Arts - Medical Administrative
Lone Star College System
Spring, TXHigh School Diploma -
Nimitz High School
Houston, TX05.2002
Medical Assistant - Medical As
Sanford–Brown
08.2003 - 05.2004
Skills
- Charting and clinical documentation
- Multi-line phone operations
- 10-key proficiency
- Patient scheduling
- Medical claims
- Administrative support
- Regulatory compliance
- Claims management
- Account management
- Client assessment
Timeline
Claims Specialist IIl
PFS
09.2022 - Current
Billing Specialist
Arthritis Knee Pain Centers
12.2020 - 09.2022
Medical Administrative Assistant
R and R Rehabilitation
03.2014 - 11.2019
Medical Assistant - Medical As
Sanford–Brown
08.2003 - 05.2004
Associate of Arts - Medical Administrative
Lone Star College System
High School Diploma -
Nimitz High School