SHAKIMA WIGGINS
Miami,FL
Summary
Healthcare and Revenue Cycle professional with 15+ years of experience supporting healthcare operations, patient access, insurance verification, claims processing, and reimbursement workflows. Experienced using Epic, Cerner, FinThrive, iPAS, NextGen, Availity, and payer portals to access, review, and document patient and insurance information. Skilled in identifying system and data discrepancies, researching workflow and coverage issues, coordinating resolutions across departments, and maintaining accurate documentation. Brings extensive end-user healthcare operations knowledge and a strong understanding of how technology supports patient access, financial clearance, and revenue cycle performance.Relocating to Georgia | Seeking Remote or Hybrid Opportunities | Available to Work in Georgia
Overview
17
17
years of professional experience
Work History
PATIENT ACCESS / REGISTRATION REPRESENTATIVE
Jackson Health System
Miami, FL
01.2026 - Current
- Facilitated patient registration across various healthcare services to ensure smooth intake. across high-volume outpatient, specialty, diagnostic, and surgical services.
- Utilized Epic, Cerner, FinThrive, and iPAS to document patient information, verify coverage, and enhance patient access and revenue cycle operations.
- Review insurance eligibility, benefits, coverage requirements, referrals, and prior authorization status.
- Coordinated with insurance carriers, physician offices, patients, and clinical departments to efficiently research and resolve access-related issues.
- Identify registration, demographic, insurance, and coverage discrepancies that may affect patient access or reimbursement.
- Maintained accurate documentation and ensured HIPAA compliance while managing time-sensitive requests to support patient care.
- Assisted in Nuclear Medicine operations to streamline patient care processes.
LEAD INSURANCE VERIFICATION SPECIALIST
Care Resource Community Health
Miami, FL
03.2019 - 12.2025
- Led insurance verification activities and supported healthcare workflows involving eligibility, benefits, referrals, authorizations, and financial clearance.
- Researched payer requirements, coverage limitations, and reimbursement guidelines, resolving insurance-related issues to facilitate timely claims processing.
- Used payer portals and insurance systems to verify information, investigate discrepancies, and document findings.
- Coordinated with billing, coding, providers, and medical records teams to gather documentation for claim resolution and appeals, enhancing overall claim accuracy.
- Investigated denied, delayed, and underpaid claims, performing accounts receivable follow-up to recover revenue and improve cash flow.
- Researched payer requirements, coverage limitations, and reimbursement guidelines to resolve insurance-related issues.
- Reviewed EOBs and payment variances to identify reimbursement discrepancies.
- Maintained HIPAA, payer contracts, and regulatory compliance.
BILLING & REVENUE CYCLE SPECIALIST
Audiology Management Group
Miami, FL
08.2016 - 02.2019
- Processed medical claims while researching payer requirements to ensure accurate billing and reimbursement.
- Reviewed EOBs and payment variances to identify and resolve discrepancies, enhancing accuracy in claims processing.
- Followed up on unpaid, denied, and underpaid claims.
- Coordinated corrected claims, rebilling, and secondary billing to streamline revenue cycle and ensure compliance with coding updates.
- Posted payments, reconciled accounts, and maintained accurate billing records.
SR. INSURANCE VERIFICATION SPECIALIST
University of Miami Hospital
Miami, FL
03.2013 - 07.2016
- Verified insurance eligibility and benefits, ensuring compliance with coverage requirements for healthcare services.
- Researched payer policies, identifying and documenting authorization, referral, and coverage requirements for efficient claims processing.
- Communicated with insurance carriers to clarify benefits and resolve coverage issues, facilitating timely reimbursement.
- Maintained accurate insurance documentation to support financial clearance and reimbursement.
SENIOR CLAIMS REPRESENTATIVE / REVENUE CYCLE SPECIALIST
US MED
Miami, FL
01.2010 - 03.2013
- Reviewed healthcare claims for billing accuracy, ensuring timely reimbursement.
- Investigated claim discrepancies while clarifying payer requirements to resolve issues.
- Followed up on denied, unpaid, and underpaid claims to secure payments.
- Supported accounts receivable, collections, payment review, and reimbursement recovery.
Education
High School Diploma -
Miami Jackson Senior High School
Miami, FLDiploma - Medical Insurance Billing & Coding
Everest Institute
Miami, FLSkills
- Patient Access and Registration
- Epic
- Cerner
- FinThrive
- IPAS
- NextGen
- Availity
- Payer Portals
- Benefits verification
- Referral requirements
- Claims Processing Support
- Revenue cycle operations
- Application support
- Issue Identification and Resolution
- Workflow knowledge
- Data Entry Accuracy
- Interdepartmental Collaboration
- HIPAA compliance
- Microsoft Office
- Google Workspace
- Google Workspace
Personal Information
Title: Healthcare Systems | Application Support | Revenue Cycle Operations
Timeline
PATIENT ACCESS / REGISTRATION REPRESENTATIVE
Jackson Health System
01.2026 - Current
LEAD INSURANCE VERIFICATION SPECIALIST
Care Resource Community Health
03.2019 - 12.2025
BILLING & REVENUE CYCLE SPECIALIST
Audiology Management Group
08.2016 - 02.2019
SR. INSURANCE VERIFICATION SPECIALIST
University of Miami Hospital
03.2013 - 07.2016
SENIOR CLAIMS REPRESENTATIVE / REVENUE CYCLE SPECIALIST
US MED
01.2010 - 03.2013
High School Diploma -
Miami Jackson Senior High School
Diploma - Medical Insurance Billing & Coding
Everest Institute