Medical Billing Specialist with 10+ Years Experience

Jessica Sikes

Nichols, SC *****

n **********@*****.*** n 843-***-****

Professional Summary

Detail-oriented and highly efficient Medical Billing Specialist with over a decade of experience in oncology, anesthesia, pathology, neonatology, inpatient, and emergency room billing. Skilled in claims management, appeals, and revenue cycle operations with a proven ability to resolve complex insurance issues. Adept at working with commercial and private insurance carriers, Medicare, and Medicaid. Proficient in multiple EMR and billing platforms including Intergy, Kredo, Nextgen, Athena, and Realmed. Known for accuracy, confidentiality, and strict adherence to HIPAA regulations. Recognized as a reliable team player with strong organizational and communication skills. Professional Experience

Retail Associate / Key Holder – Black Market Minerals – Myrtle Beach, SC April 2024 – May 2025

• Delivered excellent customer service by assisting customers and processing transactions accurately.

• Maintained merchandise displays and ensured a clean, organized sales environment.

• Handled cash register operations, including balancing drawers and managing returns.

• Supported loss prevention efforts and contributed to a collaborative team environment. Patient Account Specialist – E5 Flex – Remote

July 2020 – September 2021

• Verified patient insurance coverage and ensured accurate claim submission.

• Followed up on submitted claims and updated patient accounts with insurance changes.

• Maintained compliance with HIPAA and payer guidelines. Patient Account Specialist II – Shenandoah Oncology – Winchester, VA July 2016 – November 2019

• Reviewed and scrubbed claims for accuracy; corrected and resubmitted rejected claims.

• Processed and posted patient payments and worked denied claims to secure reimbursement.

• Trained new staff on billing procedures and compliance.

• Ensured timely and accurate charge submission using electronic systems. Specialist (Temp Position) – GPRO – Arlington, VA

January 2016 – April 2016

• Analyzed patient charts across multiple EMR systems to meet CMS reporting requirements.

• Collaborated with team members to meet strict deadlines and compliance standards.

• Reported daily progress to ensure accuracy and efficiency. Appeals Analyst – EMA – Germantown, MD

September 2010 – January 2014

• Reviewed medical records and coding accuracy for insurance compliance.

• Completed and submitted appeals to secure proper payment.

• Resolved underpayments and tracked claims to completion.

• Prepared patient statements and ensured compliance with payer regulations. Accounts Receivable Representative – AHMA – Frederick, MD January 2008 – September 2010

• Investigated past due accounts and minimized unpaid balances.

• Entered procedure and diagnosis codes accurately for anesthesia billing.

• Identified errors, re-filed denied claims, and ensured reimbursement compliance. Supervisor / Customer Advocate – United Healthcare – Frederick, MD July 2001 – May 2005

• Assisted members and representatives with escalated claims issues.

• Ensured claims were processed accurately and in compliance with regulations.

• Tracked claim trends to identify and prevent recurring issues.

• Acted as liaison between patients, doctors, and insurance providers. Education

High School Diploma or Equivalent

Skills

Medical Billing & Coding (ICD-9, ICD-10, CPT) • Claims Review, Appeals & Collections • Insurance Verification (Medicare, Medicaid, Commercial, Private) • EMR Systems: Intergy, Kredo, Nextgen, Athena, Realmed • Accounts Receivable / Revenue Cycle Management • HIPAA Compliance • Microsoft Office Suite (Word, Excel, Outlook) • Strong Communication & Customer Service

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