Shawteriyah Golphin
Lorton,VA
Summary
Detail-oriented Medical Biller and Insurance Specialist with 7+ years of experience in pediatric billing, insurance verification, referrals, and patient account management. Skilled in EMR systems, claims processing, prior authorizations, collections, and high-volume patient communication. Strong ability to resolve discrepancies, explain insurance benefits, and support families with professionalism and empathy. Brings proven success in both in-office and fully remote healthcare environments, with excellent accuracy, communication, and workflow management.
Overview
11
11
years of professional experience
Work History
Referral Specialist (Remote)
Tribeca Pediatrics
01.2024 - 10.2024
- Coordinated referrals for pediatric patients, ensuring timely access to specialist care based on insurance requirements.
- Verified insurance eligibility and benefits; obtained prior authorizations and documented approval details.
- Communicated with families, providers, specialists, and insurance representatives to support continuity of care.
- Managed referral data across EMR systems and insurance portals; ensured accurate record-keeping and follow-through.
- Assisted families with scheduling concerns, referral questions, and insurance navigation.
- Ensured compliance with payer guidelines to prevent claim denials and processing delays.
Billing Specialist (Remote)
Tribeca Pediatrics
10.2021 - 01.2024
- Generated and sent accurate patient invoices; identified and corrected billing discrepancies.
- Processed payments, posted transactions, and maintained detailed patient account records.
- Monitored aging reports and followed up on past-due balances to improve collections.
- Entered patient demographics, insurance, and financial data with high accuracy.
- Assisted caregivers with billing questions by phone and email, providing clear explanations of benefits, deductibles, and charges.
- Collaborated with the clinical and administrative team to resolve coding issues and ensure clean claims.
Call Center Representative (Hybrid - Remote 2020)
Tribeca Pediatrics
02.2017 - 10.2021
- Managed high-volume inbound calls and emails from patients and families; scheduled, rescheduled, and confirmed appointments.
- Routed detailed messages to providers and clinical staff for timely follow-up.
- Maintained accurate patient records in the EMR and ensured insurance information was current.
- Provided clear, compassionate support on practice policies, visit types, insurance questions, and procedures.
- Adapted successfully to remote work beginning June 2020, maintaining performance and productivity in a virtual environment.
Community Manager - Student Housing
United Group
05.2013 - 06.2015
- Served in a hybrid role similar to a Resident Assistant and leasing office support.
- Assisted residents with housing concerns, conflict resolution, and community policies.
- Supported leasing tasks including move-ins, inspections, housing assignments, and administrative office duties.
- Organized and led community engagement events for student residents.
- Performed data entry, maintained resident files, and handled communication with students and parents.
- Responded to after-hours situations and helped maintain a safe community environment.
Education
Associate of Science - Culinary Arts
Schenectady County Community College
Schenectady, NYSkills
- Medical Billing
- Insurance Verification
- Prior Authorizations
- Claims Processing
- Patient Account Management
- Payment Posting
- EMR/EHR Systems
- HIPAA Compliance
- High-Volume Call Handling
- Data Entry & Accuracy
- Appointment Scheduling
- Customer Service
Timeline
Referral Specialist (Remote)
Tribeca Pediatrics
01.2024 - 10.2024
Billing Specialist (Remote)
Tribeca Pediatrics
10.2021 - 01.2024
Call Center Representative (Hybrid - Remote 2020)
Tribeca Pediatrics
02.2017 - 10.2021
Community Manager - Student Housing
United Group
05.2013 - 06.2015
Associate of Science - Culinary Arts
Schenectady County Community College