Medical Billing Customer Service

LANRE RAJI

Email: *********@*****.*** Phone: 469-***-****

Position: Follow-Up SpecialistPERSONAL STATEMENT

Detail-oriented and highly efficient Medical Billing Specialist with comprehensive expertise in inpatient, outpatient, and physical medical billing. Strong command of HIPAA regulations, Electronic Health Records (EHR) systems, and insurance terminologies. Proven ability to accurately file claims, resolve denials, and manage insurance appeal processes. Adept at addressing customer complaints with a friendly, solutions-driven approach. Proficient in Microsoft Office Suite and skilled in various EMR and Practice Management Software such as Epic, Cerner, Dr. Chrono, and Kareo Billing. Known for exceptional problem-solving abilities, outstanding interpersonal skills, and delivering top-tier customer service while maintaining strict adherence to HIPAA compliance.KEY SKILLS

Medical Billing (Inpatient, Outpatient, Physical)

Claims Filing, Denial Resolution, and Insurance Appeals

HIPAA Regulations and Compliance

Electronic Health Records (EHR) Systems

Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

Customer Service and Client Relations

Problem-Solving and Complaint Resolution

Data Entry and Management

Patient Statement Processing

EMR Software Proficiency

Practice Management Software (Epic, Cerner, Dr. Chrono, Kareo Billing, Medpointe, Jira Service Desk, Zendesk)

Strong Interpersonal and Communication SkillsPROFESSIONAL EXPERIENCE

Cognizant

AR Follow-up Specialist May 2022 - Present

Manage follow-up on denied and unpaid claims, ensuring timely and accurate resolutions through Epic software.

Collaborate with insurance payers to investigate incorrect denials, facilitating reprocessing and payment corrections.

Analyze claim trends and identify opportunities for resolution to improve revenue cycle outcomes.

Ensure accurate account reconciliations, including posting payments, adjustments, and transferring balances per EOB protocols.

Efficiently manage prior authorizations and ensure compliance with billing standards.

Provided high-quality service by resolving complex customer inquiries related to health insurance benefits.

Drive productivity through special projects and HIPAA-compliant billing practices.

Aya Healthcare

AR Follow-up Representative July 2020 - May 2022

Processed electronic and paper claims with accuracy and timeliness, resolving denials and achieving maximum reimbursement.

Conducted insurance benefit investigations across multiple service lines and communicated findings to key stakeholders.

Performed follow-up on unpaid accounts, focusing on Medicare, Medicaid, and commercial insurance payers.

Successfully appealed denied claims, tracked submissions, and provided solutions for patient billing inquiries.

Effectively communicated plan policies and resolved eligibility issues by coordinating with internal departments, external plans, and government agencies.

Maintained strict adherence to HIPAA guidelines while working closely with patients to create payment plans.

Coder

Payment Poster Mar 2019 – April 2020

Efficiently posted insurance and patient payments, handling both electronic and manual processes.

Communicated with insurance companies to resolve missing EOBs and reconciled posting errors with the AR team.

Generated and processed patient statements, performed corrected claim submissions, and ensured data accuracy in multiple systems.

Ensured member satisfaction by delivering accurate information, maintaining proper documentation, and upholding a professional demeanor in every interaction.

Maintained a detailed production log and collaborated effectively with internal teams for continuous process improvements.

EDUCATION

B.Sc. in Public Administration University of AE 2010

CERTIFICATIONS

CompTIA Network+

PMP (PMI)

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