Revenue Cycle Specialist with 8+ Years Experience
Resume:
O L A Y I N K A
B U S A R I
***************@*****.***
Stafford,Virginia 22554
PROFESSIONAL SUMMARY
Dedicated Revenue Cycle Specialist with 8+ years of experience in Account Receivable functions focused on completing work quickly to consistently exceed targets. Reliable team member accustomed to taking on challenging tasks. SKILLS
Analytical Financial reporting
Task prioritization Computer skills
Organization and time management Claims processing Invoicing proficiency Payment posting
Collections HIPAA compliance
Account Receivable Medical billing
Customer service Dispute resolution
ERP systems
EXPERIENCE
A/R Follow-up, K & H Medical Billing Specialists, Mar 2024 Current, Manassas, VA.
Compile and submit claims to insurance companies for payment and subsequently bill patients.
Calculated adjustments, premiums and refunds.
Review and appeal unpaid and denied claims.
Answering patients' billing questions.
Handling collection of unpaid accounts.
Working directly with insurance companies, health providers, and patients to process claims and ensure payments.
Make timely and independent decisions.
Review delinquent accounts and call for collection purposes. Investigating rejected claims to see why denial was issued. Monitor billing errors and timely re-bill.
Advise best practice solutions to moderately complex problems including absent payment files and electronic posting efficiencies. Review current denials on account to educate and updates staff with changes needed for proper processing.
Clearly communicate with management regarding problems and opportunities for resolution on a timely basis.
OB
Tracking accounts receivable to ensure accuracy.
Maintains records and files as appropriate.
Perform quality assurance checks to ensure procedures are adhered to. Interact with employees, medical center administrative staff, physician and office staff.
Revenue Cycle Specialist, Golden Spang Medical & eekfs, Billing Dec4 & Benefits, kl Dec 2022 Mar 2024, Houston, TX
Managed processing of credit memos and adjustments, determining accurate recordings.
Conducted investigations to resolve billing disputes and discrepancies. Generated and sent accurate invoices to clients, facilitating collection of funds. Compiled and shared reports with management on pending payments, accounting, and statements involving ageing reports and month-end closing reports. Communicated with customers regarding outstanding balances for timely payments. Played a crucial role in protecting the company's value by keeping information confidential.
Cross-checked and verified accuracy of invoices and requisition forms before sharing with clients.
Achieved accounts receivable targets and contributed to company's profitability in securing revenues by verifying and posting accurate receipts. Collaborated with internal teams to reconcile customer accounts. Troubleshot and resolved issues and discrepancies of billed amounts on invoices. Reconciled or reported discrepancies identified in records, taking action to prevent future incidents.
Observed all local, state and federal requirements to reduce corporate risk pertaining to billing and healthcare requirements.
Minimized errors and variances with robust reconciliation processes. Investigated and resolved discrepancies during account reconciliation process. Navigated accounting software to record, store and analyze information. Applied payment, adjustments, and denials into system. Patient Account Representative, Billing Plus, Inc, Feb 2021 Dec 2022, Bowie, MD Handled incoming and outgoing mail, and matched EOB statements to patient accounts.
Translated health care services into coded medical claims for submission to insurance carriers.
Verified coverage with insurers, filed required forms and submitted paperwork to obtain timely payments.
Explained charges to patients and assisted with resolving discrepancies. Assembled patient billing data for services, prescriptions, insurance coverage, copayments and deductibles.
Coordinated with the nursing department to obtain information for billing. Completed bills by collecting clinical and laboratory testing information for inclusion. Answered questions from patients regarding billing charges by explaining services and clinical duties performed.
Followed up on submitted insurance claims to mediate disputes and obtain reimbursement for services rendered.
Collected required information from medical units to prepare bills. Assists in the End of Month process. Monitor online claims submission and correct any denial/rejections.
Performs all data entry required for entry of patient payments and insurance payments into computer system.
Ensures that the electronic and hard copy billing is complete and sent daily. Negotiated settlements and payment agreements with customers. Updated clients' accounts with payment details, resolving collections issues. Prioritized debt collections by periodically reviewing accounts. Collected payments, updated accounts, and notified customers of additional responsibilities.
Processed payments from debtors by phone, email and online methods. Updated debtor accounts with personal information and purged inactive records. Resolved account issues via communications with employers, insurance companies and labs.
Resolved potential delays and trends with payors through corrective actions to avoid AR aging.
Medical Billing Specialist, Enhanced Medical Billing Service, Sep 2019 Jan 2021, Desoto, TX
Liaised with hospital contacts to resolve billing errors. Advised finance staff and providers regarding changes to procedural and billing codes from Medicare, Medicaid and private insurance carriers. Obtained claim status to update patient billing.
Upheld confidentiality regarding protected health information and adhered to HIPPA regulation.
Applied changing policies and guidelines to billing actions. Resolved accounts quickly and accurately to obtain maximum reimbursement. Notified registration team of errors in enrollment, patient information or identification verification.
Handled incoming and outgoing mail, and matched EOB statements to patient accounts.
Conducted research on overdue billing by contacting patients, local affiliates and insurance carriers.
Translated health care services into coded medical claims for submission to insurance carriers.
Answered questions from patients regarding billing charges by explaining services and clinical duties performed.
Assembled patient billing data for services, prescriptions, insurance coverage, copayments and deductibles.
Completed bills by collecting clinical and laboratory testing information for inclusion. Collected required information from medical units to prepare bills. Reviewed clinical statements and assigned standard codes using CPT, ICD-10-CM, or HCPCS Level II.
Account Receivable Specialist, Complete Billing Services, LLC, Apr 2016 Aug 2019, Greenwood, IN
Communicated with customers regarding outstanding balances for timely payments. Troubleshot and resolved issues and discrepancies of billed amounts on invoices. Conducted investigations to resolve billing disputes and discrepancies. Played crucial role in protecting company's value by keeping information confidential.
Acquired insurance authorizations for procedures and tests ordered by the attending physician.
Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables system and clearing house. Compile and submitted claims to insurance companies and then subsequently bill patients.
Communicated verification and authorization status updates with department to facilitate decision-making for patient admissions and insurance coverage. Processed daily invoices and payments to keep accounting records current. Attend scheduled cadence calls with team lead (weekly, bi-weekly, monthly, or quarterly) to review barriers preventing account resolution (client, payer, clearinghouse, etc.), work together as a team to resolve those issues. Add notes to any service-line balance issues for Remits team. Communicate claim issues with Team Lead if unable to resolve. Claims Customer Service Representative, Amax Insurance, Jan 2014 Mar 2016, Cedar Hill, TX
Collected, documented and entered data from and into multiple applications. Used systems for tracking, information gathering and troubleshooting. Assisted customers with phone and email requests for assistance, including policy changes and certificates of insurance.
Processed policy level transactions within level of authority. Identified, recommended and implemented customer conservation approaches to enhance policy retention.
Kept records of customer interactions and transactions, recording details of inquiries, complaints and comments, as well as actions taken. Conducted research to complete service requests.
Monitored expiration list to promptly renew expiring policies. Obtained supporting documentation from the claimants and their representatives and transferred to vendor partners.
Carefully checked and verified personal data, policy information and property values for each insurance application.
Completed accurate calculations of premiums, refunds and adjustments in line with insurance rate standards.
Modified and updated policies to reflect changes such as beneficiary names, coverage amounts and the types of insurance.
Developed rate quotes for new customers and existing policyholders. Worked with insured customers and representing agents to collect information and convey changes to the involved accounts.
Jul 2012
Teacher, Universal Basic Education Board, Nov 2012 Dec 2013, Abuja, FCT Assigned classwork and homework to enhance student understanding and study habits.
Assessed student performance and diversified approaches to meet individual student needs.
Observed school rules and policies and complied with local, state and national standards pertaining to student health and safety. Monitored classroom behavior and modeled social skills and conflict resolution to address challenges.
Encouraged curiosity and exploration of new concepts to provide diverse and comprehensive education.
Updated student records with attendance, grades, and test scores. Incorporated new technologies and instructional strategies to enhance student comprehension.
Recognized individual needs while maintaining clear, consistent academic and behavioral expectations.
Cultivated organized classroom spaces to deliver inclusive and welcoming learning experiences.
Maintained open communication with student caregivers through parent-teacher conferences and student evaluations.
Worked closely with fellow teachers and faculty teams to meet student needs. Represented school and department at required staff meetings, workshops and school functions.
Developed comprehensive lesson plans to implement core concepts and meet educational goals.
Evaluated student needs, progress, and challenges with standardized tests and supplemental assessments.
Organized materials and classroom spaces to boost teaching efficiency and success. Created specialized curriculum for workshops and development seminars. Built strong and trusting rapport with each student to encourage positive learning outcomes.
Engaged students with immersive activities to expand on lecture topics. Motivated students to tackle challenging tasks in preparation for advanced learning opportunities.
Maintained current records of student and class data with frequent updates. Mentored students through individual challenges to increase comprehension of core concepts.
Answered questions regarding lesson and lecture material, helping students better understand subject matter.
EDUCATION
Bachelor of Science, B usiness
Admin/Management Kwara state
University Ilorin, Kwara Nigeria
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