Accounts Receivable & Reimbursement Specialist

BOLANLE S GANIYU

Smyrna, GA

Email address: **************@*****.*** 404-***-****

PROFESSIONAL SUMMARY

Detail-oriented and results-driven healthcare professional with experience in patient accounting, healthcare reimbursement, and claims analysis. Skilled in calculating and reconciling contractual adjustments, and ensuring billing accuracy in alignment with payer contracts. Proven ability to leverage Epic systems, spreadsheets, and operational data to support post-payment review, identify discrepancies, and drive resolution. Credit balance analysis, and adjustment processing. Recognized for effective communication, critical thinking, and cross-functional collaboration in fast-paced healthcare environments. Eager to apply analytical and technical expertise to improve reimbursement accuracy and support revenue cycle performance.

SKILLS:

Customer Service and Communication • Database Management and Data Integrity

Contractual Adjustments & Reconciliation • Documentation and Reporting

Insurance Verification and Claim Processing • Effective Communication

Systems and technology usage • Problem-solving and conflict resolution

Cross-functional collaboration • Multitasking, Prioritization, and Accountability

Critical thinking and decision making

Quality Improvement Initiatives • Excellent organization and time management

Financial Responsibilities and Compliance • Keen attention to detail and commitment to accuracy Team Collaboration and management

Administrative and Technical • Ability to work efficiently in a fast-paced environment Continuous Improvement

Basic Mathematical Calculations • Proficient in computer applications such as

Analytics and insights Microsoft Office, Data entry and Data analysis

Data Entry and Record Management Team Leadership and Development

Credit Balance Review & Resolution

PROFESSIONAL EXPERIENCE

Wellstar Health System, Marietta GA: Customer Relation and Collections Representative III 07/2023 -- Present.

Manage and reconcile self-pay account balances, performing basic mathematical calculations to ensure accurate patient responsibility and account resolution.

Analyze account details and validate balances against payer information, identifying discrepancies, and initiating appropriate adjustments.

Review and interpret billing details and payment activity, supporting accurate reimbursement and contractual adjustment processes.

Communicate with patients and responsible parties to resolve balances, negotiate payment arrangements, and explain financial obligations clearly.

Process and document payments, maintaining detailed account notes and ensuring compliance with internal controls and audit-ready documentation standards.

Provide guidance on financial assistance programs, ensuring patients understand eligibility and application processes.

Collaborate with internal departments, physician offices, and third-party payers to resolve account issues and support claims reconciliation efforts.

Maintain strict adherence to HIPAA regulations and organizational policies.

Utilize computer systems and spreadsheet tools (e.g., Excel) to track accounts, monitor adjustments, and support reporting needs.

Consistently meet productivity and quality KPIs while contributing to special projects and process improvements.

Assist in training and supporting new team members, reinforcing best practices in account analysis and customer communication.

Wellstar Health System, Marietta GA: Patient Service Representative 08/2020 -- 06/2023

Exhibits behavior and communication skills reflecting a commitment to superior customer service and quality care for both internal and external customers.

Processed patient accounts and supported claim adjustments and reimbursement workflows, ensuring accuracy in billing and payment application.

Verified insurance coverage and interpreted benefit structures (HMO/PPO), including authorization requirements and patient liability.

Assisted in reviewing EOBs and remittance data to confirm payment accuracy and identify discrepancies requiring follow-up or adjustment.

Collected and documented patient demographic, financial, and insurance information critical for accurate billing and reimbursement.

Utilized Epic Systems and EMR platforms for account management, data entry, and tracking patient financial activity.

Communicated effectively with patients, insurance representatives, and providers to resolve billing inquiries and clarify account details.

Maintained working knowledge of hospital billing terminology, reimbursement guidelines, and regulatory requirements.

Supported credit balance review processes by identifying potential overpayments and escalating for resolution.

Entered and maintained data in spreadsheets, demonstrating proficiency with computer systems and reporting tools.

Participated in quality improvement initiatives aimed at enhancing claims accuracy and operational efficiency.

Northside Hospital Atlanta, GA: Customer Access Representative II 11/2017 - 07/2020

Arranges for efficient and accurate collection of information for orderly registration of pediatric, adult, and geriatric patients.

Collects and distributes patient information, billing information, medical history, insurance information, etc.

Entered patient information into databases and maintaining accurate records.

Communicate clearly and effectively with patients

Makes patients and families aware of hospital policies and procedures.

Provide patients with information on the financial assistance policy and application process, ensuring transparency and patient education

scheduling appointments, gathering and distributing information for patient collections and billing, and facilitating hospital admissions for patients

Bedside follow-up with patients where all necessary information was not obtained at admission.

Process discharge and re-admission requests.

Provide patients with information on the financial assistance policy and application process.

Oversaw and managed a high volume of patient’s interactions across multiple channels, including phone, and email.

Assisting in projects, working as a positive team member, rounding, and mentoring the staff for optimal performance

Effectively sort, organize, and maintain various documents to support front office functions and procedures, optimizing workflow efficiency.

Collaborated closely with internal departments to address and resolve complex patient’s issues, consistently prioritizing a customer-centric approach.

Handled patient’s inquiries and complaints, providing accurate information and resolving issues in a professional and timely manner

Participates in customer service teams.

Escalate issues as appropriate to keep supervisor informed of patient concerns

Emory Health System, Atlanta GA: Customer Service Representative 8/2016 - 10/2017

Provide Quality Customer Delight in all calls

Use proper telephone etiquette and all available resources to respond to incoming customer inquiries, requests and complaints competently and courteously

Scheduling appointments for clients

Troubleshoot inquiries and follow up with customers on issues that cannot be resolved immediately

Complete all required documentation associated with the handling of calls and maintain complete and accurate records

Follow through in a timely manner to resolve all issues and concerns

Escalate issues as appropriate to keep supervisor informed of client concerns

Quest Diagnostic Marietta, GA: Quality Assurance Technician 3/2013 – 07/2016

Conducted inspections and audits of medical supplies to ensure compliance with regulatory requirements and quality standards.

Conducted testing of medical devices to ensure they met required specifications and were safe for patient use.

Analyzed data and identified trends to develop and implement process improvements that improved product quality and reduced defects.

Developed and maintained quality control plans and documentation to ensure compliance with regulatory requirements.

Trained lab technicians on quality control procedures and standards.

Collaborated with department heads to improve processes and reduce errors.

Conduct regular audits to ensure adherence to quality control procedures.

NIA Soule Franchise LLC, Norcross GA: Data Entry Specialist 04/2011 - 02/2013

Provided exceptional service to clients through accurate and efficient data entry processes.

Managed and updated client databases, ensuring the integrity and completeness of information.

Effectively addressed and resolved a variety of client complaints.

Coordinated and scheduled appointments for clients, optimizing organizational efficiency.

Ensured clients' satisfaction by delivering high-quality services and promptly addressing their needs.

BI-Courtney Aviation Service, Lagos Nigeria: Customer Care Consultant 01/2000 – 03/2010

Provide quality customer service on every call.

Handles all sort of correspondence, including inquiries and complaints, for airlines

Inputting passengers’ data base into Excel word.

Communicate clearly and effectively with passengers

Giving passengers information on flight schedule.

Organize and prioritize general administrative duties

Commitment to continuously improving the quality of Company Operations

And services so as to meet customers’ needs.

EDUCATION & CERTIFICATIONS

Bachelor's degree in finance

Gwinnett Technical College, Lawrenceville GA: GED/ High School Diploma

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