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Kenya Hicks Page *

KENYA HICKS

CLAIMS EXAMINER BEHAVIORAL HEALTH & MEDICAL CLAIMS SPECIALIST

Bakersfield, California 818-***-**** ***********@*****.*** PROFESSIONAL SUMMARY

Experienced claims examiner and behavioral health claims professional with 6+ years of healthcare claims experience. Skilled in medical and behavioral health claims processing, claims review and investigation, ICD and CPT code identification, medical billing review, provider discrepancy resolution, and accurate claims documentation. Proficient in Epic and Tapestry, with additional knowledge of healthcare credentialing and CAQH. Experienced in researching claim discrepancies, communicating with providers, monitoring claims for timely processing, resolving patient concerns, and training team members on claims procedures. CORE COMPETENCIES

Medical Claims Processing Behavioral Health Claims Claims Review & Investigation ICD & CPT Codes Medical Billing Review Provider Communication Claims Documentation Healthcare Credentialing & CAQH Epic, Tapestry & Data Entry PROFESSIONAL EXPERIENCE

Rose International Agency Behavioral Health Claims Examiner Feb 2025 - May 2026

• Reviewed and processed behavioral health and medical claims using Epic and Tapestry.

• Identified ICD and CPT codes and reviewed claim information for accuracy and completeness.

• Conducted detailed claims investigations to identify discrepancies and processing issues.

• Collaborated with healthcare providers to research and resolve claim discrepancies and facilitate timely payment.

• Reviewed medical bills for billing errors, inconsistencies, and accuracy.

• Maintained detailed documentation and monitored assigned claims to support accurate, timely processing.

• Responded to and investigated patient concerns and claim-related issues professionally through email.

• Assisted with training new team members on claims processing procedures. Cedars-Sinai Claims Examiner Jan 2023 - Jan 2025

• Reviewed and processed medical claims using Epic and Tapestry, verifying accuracy and completeness.

• Investigated claims and partnered with providers to resolve discrepancies.

• Reviewed medical billing information for errors and maintained accurate claims documentation.

• Responded to patient concerns and assisted with team-member training. KENYA HICKS Claims Examiner Behavioral Health & Medical Claims Kenya Hicks Page 2

PROFESSIONAL EXPERIENCE CONTINUED

Jul 2019 - Jan 2023

• Reviewed and processed healthcare claims using Epic and Tapestry.

• Investigated claims for accuracy and collaborated with providers to resolve discrepancies.

• Reviewed billing information for errors and maintained complete claims documentation.

• Responded to patient concerns and assisted with new-hire training. PennyMac Loan Services Loan Processor Aug 2015 - May 2019

• Processed and reviewed confidential loan applications and supporting documentation.

• Verified financial and employment documentation for accuracy and completeness.

• Maintained confidential information using Encompass and communicated with customers regarding outstanding documentation.

• Ensured required documentation complied with financial requirements. Harbor-UCLA Medical Center Processing Coordinator & Administrative Assistant

Jun 2012 - Apr 2015

• Provided administrative and clerical support in a medical center environment.

• Maintained electronic and paper records and prepared professional correspondence.

• Responded to inquiries and managed documentation, scanning, filing, and data entry. EDUCATION

Bachelor of Business Administration 2016

Ashford University

TECHNICAL & HEALTHCARE SKILLS

Epic • Tapestry • Encompass • Behavioral Health Claims • Medical Claims Processing • Claims Investigation • ICD and CPT Codes • Medical Billing Review • Provider Communication • Claims Documentation • Credentialing • CAQH

CalOptima Health Claims Specialist

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