Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shaniqua Hawkins

Waldorf

Summary

Reliable and detail-focused Medical Claims and Billing Specialist with 3+ years of experience supporting remote healthcare operations, including claims processing, insurance verification, and high-volume data entry. Proven success working in fast-paced virtual environments using platforms like Availity, Epic, and payer portals to accurately process and resolve medical claims for Medicare, Medicaid, and commercial plans. Skilled in ICD-10, and CPT coding, denial resolution, and benefit coordination. Committed to HIPAA compliance, data accuracy, and delivering excellent customer service in a fully remote setting.

Overview

2026
2026
years of professional experience

Work History

Dispute Resolution Coordinator

J29 Inc
03.2023 - 07.2025
  • Handled dispute resolution cases under the Federal Independent Dispute Resolution (IDR) process in compliance with the No Surprises Act.
  • Ensured timely submission of claims to arbitration entities as mandated by federal timelines and regulations.
  • Communicated with insurance carriers and providers to gather required data, including payment offers and supporting documentation.
  • Ensured adherence to all CMS regulations, HIPAA privacy requirements, and applicable federal/state dispute resolution laws.

Medical Claims Processor

TTEC
01.2020 - 02.2022
  • Process high-volume medical claims for outpatient, inpatient, and physician services with 98% accuracy.
  • Analyze EOBs and ERAs to post payments, identify discrepancies, and reconcile balances.
  • Maintain detailed claim records and meet productivity benchmarks for daily submissions.
  • Communicate with payers to resolve denials and underpayments; submit appeals with supporting documentation.

Claims Benefit Specialist

Platinum Choice Healthcare
2018 - 2020
  • Accurately processed medical claims for hospital, outpatient, and specialty services in alignment with payer policies and plan benefits.
  • Verify patient insurance eligibility and benefits prior to claim submission and inform providers of coverage gaps.
  • Enter and process up to 100+ medical claims per day across inpatient, outpatient, and specialist services with 98%+ accuracy.
  • Maintain HIPAA-compliant records of claims, appeals, and provider communications.

Education

General Studies

Thomas Stone High School
Waldorf, MD
06.2012

Skills

  • Claims Processing & Adjudication
  • Medical Insurance Verification
  • HIPAA Compliance
  • High-Volume Data Entry & Accuracy
  • Microsoft Excel & Word
  • Time Management
  • Organization & Multitasking
  • Confidentiality & Data Security Awareness
  • Typing Speed 60 WPM with 98% Accuracy

Timeline

Dispute Resolution Coordinator

J29 Inc
03.2023 - 07.2025

Medical Claims Processor

TTEC
01.2020 - 02.2022

Claims Benefit Specialist

Platinum Choice Healthcare
2018 - 2020

General Studies

Thomas Stone High School
Shaniqua Hawkins