Shikeema Francis

Customer service-oriented professional with a strong background in healthcare, management, and data entry. Skilled in providing timely and accurate data for reimbursement of patient services, while effectively communicating with coworkers, patients, and staff. Committed to following policies, procedures, and guidelines to maintain high-quality standards. Dedicated to safeguarding patient privacy and confidentiality. Results-driven case management professional with a proven track record of effective client advocacy and support. Experienced in conducting thorough assessments and developing individualized care plans to meet the unique needs of each client. Adept at collaborating with multidisciplinary teams and adapting to dynamic situations for optimal client outcomes.

• Department of Social Services of South Carolina, Bishopville, SC, Eligibility Case Manager, 04/24, 03/25, Responsible for conducting telephone interviews to assist clients with determining eligibility for SNAP and FI applications., Collecting and verifying information to determine initial and continued eligibility for benefits., Maintain client files with precision, safeguarding confidentiality and data security.
• Teleperformance (Work From Home), Sumter, SC, Customer Service, 01/22, 03/24, Handle inbound/outcalls, ensuring HIPAA compliance and member verification., Facilitate PCP changes and track requests for seamless member transitions., Assist members with insurance eligibility, adjustments, appeals and grievances.
• RNR (Rent N Roll Tire Express), Sumter, SC, Collection Credit Manager, 06/21, 12/21, Managed customer transactions, ensuring accurate financial handling and account updates., Handled account agreements, maintaining compliance and reducing discrepancies., Utilized technical tools for transaction management, improving processing speed.

• Medical Billing
• Accounts Receivable
• Collections
• Co-Pay
• Deductibles
• Co-Insurance
• EOBs
• Workers Compensation
• Revenue Cycle Management
• Posting Payments
• Government (Medicare & Medicaid)
• Third Party Payers
• Electronic Health Records (EHR)
• Electronic Medical Records (EMR)
• Managed Care (HMO, PPO, and POS)
• Insurance Verification
• Insurance Claim Processing
• CMS 1500
• CMS 1450 (UB-04)
• Front Office Operations
• Medical Office Procedures
• Scheduling
• Medical Terminology
• Anatomy & Physiology
• HIPAA Compliance
• Medical Coding (ICD-10-CM, HCPCS, CPT)