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Kameshia Guion

@kameshiaguion

Pharmacy billing and claims specialist with 11+ years improving reimbursement accuracy, workflow efficiency, and compliance.

United States
Message

What I'm looking for

I’m looking to support end-to-end prescription processing—insurance verification, claims resolution, and reimbursement workflows—while improving billing accuracy, streamlining processes, and strengthening compliance. I thrive on solving complex payer issues and reducing claim delays.

I’m a Certified Pharmacy Technician (CPhT) with 11+ years of experience spanning hospital pharmacy operations and pharmacy billing/ revenue cycle management. I bring clinical pharmacy knowledge plus strong analytical and problem-solving skills to improve billing accuracy, streamline workflows, and support compliance with payer and regulatory requirements.

As a Billing Specialist at PharMerica (Remote), I process pharmacy claims for adjudication and ensure accurate billing to Medicare, Medicaid, and commercial insurance providers. I investigate and resolve rejected and denied claims by analyzing payer responses and correcting billing discrepancies, performing charge entry, adjustments, and account reconciliation to prevent revenue leakage—while maintaining detailed records of billing activities and outcomes.

Previously at WakeMed Hospital, I operated automated medication carousel systems and managed Pyxis inventory, maintaining accurate par levels, monitoring expiration dates, and training and onboarding new pharmacy technicians to support medication safety and faster readiness for independent performance. Earlier, as a Pharmacy Team Member at Target CVS Pharmacy, I resolved complex prescription and insurance issues in fast-paced retail, balanced speed, accuracy, and compliance, and helped improve prescription processing efficiency by supporting timely resolution of insurance and fulfillment issues.

Experience

Work history, roles, and key accomplishments

WakeMed Hospital logoWH
Current

Certified Pharmacy Technician

WakeMed Hospital

Mar 2021 - Present (5 years 1 month)

Operated automated medication carousel/Pyxis workflows to retrieve, stage, and deliver patient-specific medications across multiple hospital units while supporting pharmacists with medication-related inquiries. Managed Pyxis inventory (par levels and expirations), ensured compliance and medication safety, and trained new technicians—improving medication turnaround time through streamlined distribu

PH

Billing Specialist

Jun 2024 - Apr 2026 (1 year 10 months)

Processed pharmacy claims for adjudication by Medicare, Medicaid, and commercial payers, resolving rejected and denied claims by correcting billing discrepancies. Performed charge entry, adjustments, and account reconciliation while maintaining compliant billing records, contributing to reduced claim processing delays.

Target CVS Pharmacy logoTP

Pharmacy Team Member

Target CVS Pharmacy

Mar 2012 - Mar 2021 (9 years)

Resolved complex prescription and insurance issues for customers in both in-person and high-volume call environments by accurately entering prescription data and coordinating unfilled prescription backlogs for pharmacist review. Monitored inventory levels, submitted replenishment orders, and served as a liaison between insurance providers and customers while maintaining compliance in a fast-paced

Education

Degrees, certifications, and relevant coursework

JS

James B. Hunt High School

High School Diploma

Earned a High School Diploma from James B. Hunt High School in Wilson, NC.

Tech stack

Software and tools used professionally

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