Medical Billing Insurance Verification

Shaatira Edwards

Scranton, PA *****

***************@*****.*** 272-***-****

Authorized to work in the U.S.

Professional Summary

Dynamic and reliable healthcare support specialist with extensive experience in medical billing and coding, insurance verification, EMR systems (Epic, Intergy, Sunrise), HIPAA compliance, patient intake, and administrative support. Proven record of excellence in fast-paced call centers, triage support, and case coordination. Seeking senior-level administrative or billing roles within modern healthcare environments.

Core Competencies

Medical Billing & Coding, ICD-10 / CPT / ICD-9, Electronic Medical Records (Epic, Intergy, Sunrise), Insurance Verification, Patient Registration, Triage Call Support, HIPAA Compliance, Claims Appeals, Medical Collections, Call Center Operations, Healthcare Administration, Customer Service, Referral Management, QuickBooks, Microsoft Office Suite, Remote Healthcare Support

Professional Experience

Medicaid Eligibility Specialist

Conduent – Scranton, PA Sept 2023 – Present

• Determine Medicaid eligibility, process insurance verifications, and manage application appeals

• Maintain strict compliance with HIPAA and healthcare data systems

Patient Service Representative

AdvantageCare Physicians – Melville, NY Dec 2019 – Jan 2022

• Scheduled patient appointments and managed referrals across 30+ clinics using Epic EMR

• Handled insurance verification, prior authorizations, and prescription refill requests

Patient Care Coordinator

Carenet Healthcare Services – Scranton, PA Sept 2021 – Jan 2022

• Answered triage calls for nurses/doctors and documented cases in secure EHR systems

• Managed high call volume while delivering compassionate patient communication

Medical Collections Specialist

Transworld Systems Inc. – Melville, NY Aug 2019 – Dec 2019

• Performed medical and insurance collections, processed payments, and set up billing arrangements

• Ensured compliance with healthcare financial practices and privacy regulations

Case Management Clerk

NSLIJ Southside Hospital – Bay Shore, NY Jun 2014 – Jun 2015

• Supported case/social workers, arranged discharge transportation, and processed denials/appeals

• Conducted insurance research and administrative documentation

Education

Bachelor’s in Criminal Justice (In Progress)

Strayer University – Remote Expected Completion: 2025

High School Diploma

West Babylon High School – West Babylon, NY 2013

Certifications

Medical Billing & Coding Certification (Active)

Valid Driver’s License

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