Shaneca Hylton
Oviedo,FL
Summary
Healthcare billing and patient financial support professional with hands-on experience in Epic, accounts receivable follow-up, claims resolution, and eligibility verification. Supports timely reimbursement by reviewing account activity, correcting billing issues, and coordinating with patients, providers, and internal teams.
Overview
26
26
years of professional experience
Work History
RCM Enrollment Billing Representative
Cigna
Orlando, Florida
05.2016 - 06.2026
- Explained billing information clearly to members and providers.
- Assisted customers with inquiries regarding bills and payment options to enhance understanding and satisfaction.
- Acted as primary contact for internal departments on billing matters to facilitate effective communication and resolution.
- Updated member accounts for billing adjustments and contact details to ensure accurate and timely billing.
- Reviewed payment issues and recorded account notes.
Patient Financial Representative
NYU MEDICAL CENTER
NEW YORK, NEW YORK
11.2006 - 04.2016
- Skillfully processed medical claims in a timely manner with accuracy and identified any coding, billing and insurance discrepancies; also updated patient demographics and insurance information accordingly.
- Followed up on Emblem, United, Medicare, Empire United, and Empire Blue Cross/Blue Shield payments and collaborated with third-party payers to ensure accurate claim adjudication.
- Professionally investigated EOB Rejections, responded to large volume of telephone inquiries from patients and insurance carriers regarded outstanding accounts balance.
- Responded to patient inquiries and complaints, managed aging accounts and appeals, and resolved billing discrepancies.
- Verified insurance eligibility and updated coverage details in patient records.
- Applied payments to reduce open A/R while reviewing stays for compliance with expected reimbursement standards.
- Reconciled account discrepancies across billing, coding, and collections records.
- Ensured all regulatory requirements were met when submitting claims for payment.
- Skillfully summarized trends and initiated activities to improve timely resolution of opened accounts, controlled bankruptcy statements and transferred accounts.
- Functioned closely with billing manager to ensure proper procedures being followed in the claims department and having Knowledge of CPT and ICD-9 coding and submission procedure.
- Communicated with staff on any new findings regarding insurance and referred monthly adjustments and/or write-offs to the Billing Director.
- Examined patient accounts to verify accuracy and completeness of information.
Patient Financial Representative
ST JOSEPH MEDICAL CENTER
YONKERS, NEW YORK
04.2000 - 11.2006
- Successfully evaluated and verified patients' medical insurance coverage, controlled all inpatient and outpatient billing for the facility.
- Efficiently posted payments of $125k to $200k per day from insurance companies to patient account, researched misdirected and missing payments from patients and insurance companies.
- Revised and processed correspondence from insurance and patients, established and maintained positive business relationships with clients, and interpreted charges and policies for patients regarding bill payments.
- Investigated and resolved issues through phone and written communication with patients and insurance.
- Examined account records for additional data to correct information and rebill, summarize trends, and initiated activities to enhance timely resolution of open accounts.
Education
High School Diploma -
Convent of Mercy Academy
Kingston, Jamaica, W.I.01-1996
Skills
- Patient accounting and billing
- Electronic claims processing
- CPT and ICD-9 knowledge
- Payment posting
- Accounts receivable follow-up
- Account adjustments
- Account reconciliation
- Medical insurance management
- Epic systems expertise
- Office and Epic proficiency
- Analytical skills
- Customer education
- Team collaboration
- Patient management
Personal Information
Title: Patient Financial Service
Timeline
RCM Enrollment Billing Representative
Cigna
05.2016 - 06.2026
Patient Financial Representative
NYU MEDICAL CENTER
11.2006 - 04.2016
Patient Financial Representative
ST JOSEPH MEDICAL CENTER
04.2000 - 11.2006
High School Diploma -
Convent of Mercy Academy