Follow Up Revenue Cycle
Resume:
OBOYE OLALEYE
Dallas, TX ***** • 214-***-**** • *********@*****.***
Professional Summary
An Experienced Revenue Cycle Specialist with superior skills working in ensuring compliance, maximizing collections, both team base, follow up procedures and processes and independent capacities, bringing forward 5 years of experience and in-depth understanding of claim denial management, improving revenue enhancement, and conducting diligent follow up of claims.
Skills
Debt Collection Procedures
Writing Reports
Claims Review
Coordinating Documents
Hospital billing/UB04
Revenue Cycle Management
Claims Processing Proficiency
Denial Management
Electronic Health Records
Customer Service
Multitasking Capabilities
Maintaining detailed records
Insurance Verification
Medical Billing
PROFESSIONAL QUALIFICATIONS
AR Follow up Representative, 04/2023 to 09/2024
Valued Relationship Inc – Remote
Resolve claims promptly by completing appeals as needed or driving materials and accounts to the Payer.
Monitor claim status, research rejections, denials, and documents related accounts activities.
Recognizes potential issues with claims and collections and implements solutions for improvements.
Correctly reviewing and interpreting EOBS to find denial reason on specific CPT Codes.
Understanding denial reason on payer portals and implementing correct resolution for proper reimbursements of payments.
Follow up on payments from commercial and government payers.
Take proper action on claims including sending appeals, responding to medical records requests and research resolutions to resolve claim denials.
Sending appeals to proper payers depending on denial reasons for reimbursement.
Made outbound calls to insurance companies to verify coverage, eligibility as well as claim status.
Served as a resource for staff inquiries about billing, or reimbursement issues.
Revenue Cycle Specialist, 12/2021 to 02/2023
McKesson – Dallas, TX
Contacting/sending letters to patients for patients pending balance, which is patient responsibilities applied to either copay, co-insurance, or deductible.
Responds to written correspondence received from Payer and/or Patients.
Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems.
Work and managed claims from all aging buckets including posting and appeals.
Identified and resolved payment issues between patients and providers.
Follow up with payers to ensure prompt resolution of all outstanding claims, via phone, emails, fax, or websites.
Contacted responsible parties for past due debts.
Report appeals to supervisor/manager to review if there is a strong supporting document that should be escalated at payer level.
Research missing payments and secure documents needed for posting.
Insurance Follow-Up Representative, 05/2019 - 10/2021
Laselle Network - Texas
Daily communication with insurance/payers either commercial or government to resolve discrepancies towards reimbursement on claims.
Examined and worked on claims needing medical record request from payers.
Track common claim errors, find and report inaccurate reimbursement and contractual trends.
Perform follow up actions and documents follow up activities, conversations with payers.
Investigate and coordinates insurance benefits for insurance claims across multiple lines Daily communication with insurance companies and other commercial insurers to address coordination of benefits and claim resolution.
Contact patients if the claim is missing correct information or member id is incorrect for claim to process.
Work within payer portals and interact with third-party payers and patients to resolve account balances.
Identified billing errors, underpayment or overpayment and resolved them accordingly Notating correct information on the status of claims stated by payer and finding resolution for proper reimbursement.
Review, analyze, resolve, and trend for complex claims issues and payer behavior using Client billing system, payor portals, calling the payer, and EOB review.
Customer Service Representative, 5/2018 to 3/2019
CCS Medical – Dallas, TX
Handled customer inquiries and suggestions courteously and professionally.
Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
Verifying customers insurance eligibility
Answered constant flow of customer calls with minimal wait times.
Provides product and service information and finds opportunities to improve our member and provider experiences.
Supports the other team members with several internal departments to decide proper resolution of issues.
Tracked customer service cases and updated service software with customer information.
EDUCATION &CERTIFICATION
High School Diploma: 06/2019
Associates, Collin College 05/2024
Microsoft Excel
Life & Health Insurance
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