Shereika Tucker
Midway,FL
Summary
Experienced medical billing specialist with over 15 years in managing claims processing and customer service. Proven ability to facilitate communication and expedite claim resolutions. Skilled in electronic health record systems and maintaining adherence to HIPAA regulations with Worker's Compensation. Committed to supporting organizational goals through proactive problem-solving and effective team collaboration.
Overview
19
19
years of professional experience
Work History
Research Liasion Specialist
Acentra Health
Tallahassee, Florida
03.2020 - 09.2025
- Facilitated communication between claims department and external partners.
- Adjust medical claim as necessary to expedite payments to medical providers and patients.
- Developed medical claims for Federal Worker's Compensation programs.
- Maintained accurate records in electronic health systems.
- Assisted in resolving client inquiries and concerns promptly.
- Conducted research into Medical Claims and Authorizarions in order to develop solutions that meet their requirements.
- Prepared detailed documents to trace missing checks and payments. Provide payments status and reissue the payments.
- Responded promptly to queries from Department of Labor regarding medical claims and approvals.
- Developed solutions to streamline medical claims processes for workers' compensation.
- Conducted thorough audits of denied claims to identify errors and implement corrections.
Medical Billing Specialist
Conduent
Tallahassee
09.2012 - 03.2020
- Reviewed medical records for accurate coding and billing processes.
- Processed claims and resolved billing discrepancies effectively.
- Maintained patient confidentiality while handling sensitive information.
- Researched denied claims to determine the cause of denial and corrected errors as needed.
- Processed medical claims using advanced billing software.
- Reviewed patient accounts for accuracy and completeness in documentation.
- Assisted in audits by providing necessary documentation and information promptly.
- Adhered to HIPAA regulations when handling confidential patient information.
- Applied payments, adjustments, and denials into medical manager system.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Collaborated closely with other departments to resolve claims issues.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Reviewed and verified benefits and eligibility with speed and precision.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
Choice Counseling Specialist
Automated Health Systems Inc.
Tallahassee, Florida
10.2010 - 09.2012
- Managed incoming calls and provided accurate information to clients with Florida Medicaid.
- Assisted in resolving customer inquiries and complaints efficiently.
- Documented call details accurately in the customer management system.
- Educated clients on available health services and program options.
- Responded quickly to customer inquiries via email or telephone calls.
- Researched solutions to address customer concerns using online resources or referring them to the appropriate departments within the organization.
- Created reports summarizing daily activities for management review purposes.
- Utilized problem-solving skills when presented with complex technical issues from clients.
- Recorded detailed notes in customer profiles regarding any changes made while assisting them.
- Documented all interactions with customers, including notes on the resolution of each call.
- Developed effective relationships with customers by providing friendly, helpful service.
Call Center Team Leader
ACS Xerox
Tallahassee, Florida
01.2007 - 09.2010
- Supervised daily operations of call center team to ensure efficient service delivery for Workers' Compensation.
- Monitored call metrics to identify areas for team improvement and development.
- Resolved escalated customer issues by providing effective solutions and guidance.
- Collaborated with management to implement new strategies for operational efficiency.
- Fostered a positive work environment through team-building activities and recognition programs.
- Motivated and encouraged team members through positive communication and feedback.
- Monitored call volumes and adjusted staffing schedules accordingly during peak periods.
- Maintained records of all calls received, including detailed notes regarding customer inquiries and complaints.
- Answered, screened and processed high volume of calls daily with call management system and web-based communications.
- Maintained strong call control and quickly worked through scripts to address problems.
- Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
- Participated in the recruitment and selection process for new team members.
- Answered calls with friendly and polite approach to engage callers and deliver exceptional customer service.
Education
Godby High School
Tallahassee, Florida05.2002
Skills
- Medical claims processing
- Electronic health records
- Claims resolution techniques
- Customer Service
- HIPAA regulations adherence
- Customer relationship management
- Effective communication
- Problem solving
- Attention to detail
- Proficient in Microsoft Word, Excel
- Data Entry
- Claims adjustment and management
- Patient account reconciliation
- Healthcare compliance regulations
- Billing audits and documentation
Timeline
Research Liasion Specialist
Acentra Health
03.2020 - 09.2025
Medical Billing Specialist
Conduent
09.2012 - 03.2020
Choice Counseling Specialist
Automated Health Systems Inc.
10.2010 - 09.2012
Call Center Team Leader
ACS Xerox
01.2007 - 09.2010
Godby High School