Tenika Coleman
Summary
Experienced Claims and Benefits Verification Specialist with over 10 years of experience in healthcare administration, insurance verification, claims processing, Medicaid billing, customer service, and patient support. Proven ability to verify insurance eligibility, investigate claim issues, conduct payer research, ensure regulatory compliance, and provide exceptional service to patients, providers, and insurance carriers. Skilled at managing high-volume workloads while maintaining accuracy, confidentiality, and attention to detail.
Overview
6
6
years of professional experience
Work History
Claims Specialist
TEKsystems
Charlotte
12.2025 - Current
- Verify insurance coverage, eligibility, and benefits for multiple insurance carriers.
- Review, research, and process claims to ensure accuracy and compliance with payer guidelines.
- Investigated claim discrepancies and coordinated resolutions with providers, insurance companies, and members to ensure accurate claim processing.
- Maintained detailed documentation and updated claim records within company systems to support compliance and streamline claims workflow.
- Analyze Explanation of Benefits (EOBs), claim denials, and reimbursement information.
- Delivered exceptional customer service while meeting productivity and quality standards, enhancing overall client satisfaction.
- Ensure compliance with HIPAA regulations and company policies.
Benefits Verification Specialist
AmerisourceBergen
Fort Mill
11.2021 - 10.2025
- Verified patient insurance benefits and eligibility for copay and patient assistance programs.
- Conducted extensive payer research to maximize reimbursement opportunities.
- Communicated with insurance companies, pharmacy benefit managers, providers, and patients regarding coverage and benefit information.
- Maintained accurate documentation and compliance with company and regulatory requirements.
- Supported medical billing and coding functions and assisted with claim resolution activities.
Patient Care Coordinator
Golden Care LLC
Lancaster
03.2020 - 09.2021
- Coordinated patient appointments, referrals, testing, and follow-up care.
- Served as liaison between patients, families, physicians, and specialists.
- Educated patients on treatment plans, procedures, and medications.
- Maintained patient records and ensured continuity of care
Education
Great Falls High School
Great Falls, SCSome College (No Degree) - Medical Records
University of Phoenix
Tempe, AZSkills
- Claims Processing
- Eligibility verification
- Benefits Verification
- Claims resolution
- Medical Billing & Coding
- Medicaid Billing
- Payer Research
- HIPAA Compliance
- Compliance Review
- Customer service
- Data entry
- Microsoft Office Suite
- Multi-Task Management
- Problem Solving
- Handling Confidential Information
- Account Management
Timeline
Claims Specialist
TEKsystems
12.2025 - Current
Benefits Verification Specialist
AmerisourceBergen
11.2021 - 10.2025
Patient Care Coordinator
Golden Care LLC
03.2020 - 09.2021
Great Falls High School
Some College (No Degree) - Medical Records
University of Phoenix