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
New York, NY
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
New York, NY
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
New York, NY
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
Schenectady, NY
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