Shenika Alicea
Bartow,FL
Summary
Experienced professional with a decade of expertise seeking a Claims Representative Associate position. Skilled in healthcare claims processing, medical terminology, and HIPAA compliance. Proficient in telecommuting with a strong foundation in insurance claims, policy assessment, and administrative assistance. Specializing in coding and billing, patient record review, and maintaining accurate healthcare documentation.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Medical Billing and Coding Capstone (100-Hour Externship)
Florida Technical College
10.2021 - Current
- Assign standard codes to medical records utilizing CPT and ICD-10-CM, ensuring accurate representation of patient diagnoses and procedures.
- Analyze patient health records to determine principal and secondary diagnoses, effectively assigning Diagnosis Related Groups (DRGs) for appropriate billing classifications.
- Conduct simulations for inpatient and outpatient coding across all sections of the CPT Manual, as well as for billing durable medical supplies using the HCPCS Manual.
Remote Senior Claims Resolution Specialist, Bodily
Progressive
06.2021 - 05.2025
- Evaluate insurance policy details to ascertain coverage parameters, ensuring accurate application of terms.
- Process insurance claims and Department of Motor Vehicles documentation, meticulously verifying critical data such as personal information and property values.
- Liaise with policyholders to gather necessary information, transcribe data to appropriate worksheets, and input information into digital systems for document preparation and account adjustments.
Scheduler
Lakeland Regional Hospital
01.2021 - 04.2021
- Coordinated patient appointment scheduling for COVID-19 vaccinations, ensuring timely and efficient patient flow.
- Maintained accurate medical records and correspondence, and completed insurance claim forms, enhancing the efficiency of patient processing.
- Conducted patient interviews to gather comprehensive case histories and managed documentation, while proficiently operating office systems to support medical record-keeping.
Court Clerk/Customer Services Specialist
Polk County BOCC-(Code Enforcement)
10.2014 - 09.2020
- Processed financial transactions, ensuring accurate handling of cash, checks, and electronic payments, maintaining a record of all transactions.
- Managed administrative tasks, including organizing forms, photocopying, filing records, and preparing reports, while maintaining an up-to-date database.
- Supported legal proceedings by recording court minutes, administering oaths, and preparing official documents such as orders and legal notices.
Customer Services Representative
City Of Bartow
06.2013 - 04.2014
- Resolved an average of 150 customer inquiries daily through efficient handling of phone calls, providing account information, and troubleshooting issues to deliver immediate solutions.
- Enhanced customer satisfaction by offering empathetic support for concerns and proficiently assisting both in-person and telephone-based clients, ensuring professional and courteous service.
Secratary-1/Code Enforcement Specialist II
Polk County Clerk of Courts
06.2013 - 04.2014
- Conducted comprehensive legal research to support code violation cases, ensuring thorough preparation and fact-checking for administrative hearings.
- Managed the processing of lien search requests, collaborating effectively with title companies to facilitate timely and accurate information delivery.
Education
Diploma - Medical Billing and Coding Specialist
Florida Technical College
Lakeland, FL09.2021
Skills
- CPT Coding
- HCPCS Coding
- Interpersonal Communicator
- Icd-9-Cm
- Icd-10
- Organized
- EMR Using eClinical Works
- Medicare, Medicaid, & TRICARE
- Multi-Line Phone Talent
- Health Insurance Verification
- Front Desk/Receptionist Duties
- Professional Phone Etiquette
- Microsoft Suite
- 15 Years Customer Service
- Flexible
- Self Sufficient
- Types 45 WPM
- Works Well Under Pressure
- Team Leader
- Filing and Data Archiving
- Computer Proficient
- Critical Thinker
- Attentive to Detail
- Advanced Clerical Knowledge
- Communication Skills
- Decision Making
- Attention To Detail
- Computer Skills
- Problem Solving
Certification
National Certified Insurance & Coding Specialist, NCCT, 10/01/21
Timeline
Medical Billing and Coding Capstone (100-Hour Externship)
Florida Technical College
10.2021 - Current
Remote Senior Claims Resolution Specialist, Bodily
Progressive
06.2021 - 05.2025
Scheduler
Lakeland Regional Hospital
01.2021 - 04.2021
Court Clerk/Customer Services Specialist
Polk County BOCC-(Code Enforcement)
10.2014 - 09.2020
Customer Services Representative
City Of Bartow
06.2013 - 04.2014
Secratary-1/Code Enforcement Specialist II
Polk County Clerk of Courts
06.2013 - 04.2014
Diploma - Medical Billing and Coding Specialist
Florida Technical College
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