ADEBAYO HAMZAT
DALLAS,TX
Summary
An enthusiastic, committed, and resourceful insurance claim follow-up specialist with over 3 years of experience in effective and efficient management of insurance claims and resolving discrepancies. Utilizes strong analytical skills to manage and track claim statuses. Knowledge of healthcare regulations and effective communication techniques to ensure accurate and timely resolutions.
Overview
6
6
years of professional experience
Work History
Insurance Follow up specialist
Revecore
04.2023 - Current
- Utilize Epic Systems software for assigning accurate medical codes to diagnoses and procedures.
- Sent appeals and reconsideration on claim denials
- Collaborate with revenue cycle management team to streamline processes and enhance reimbursement efficiency.
- Review medical records to ensure documentation supports code assignments and compliance with coding guidelines.
- Submit electronic claims to insurance companies and follow up on claim status.
- Resolve billing discrepancies and appeal denied claims as necessary.
- Collaborate with healthcare providers to clarify documentation and ensure accurate coding.
- Coordinated with insurance providers to expedite claim approvals and enhance payment processes.
- Trained junior staff on best practices for claims follow-up and documentation accuracy.
- Boosted revenue recovery by identifying and resolving errors in billing and coding practices.
- Monitored aged account receivables closely to identify trends affecting payment cycles.
Accounts Receivable Specialist
Omega Health
04.2021 - 03.2023
- Analyzed EOB to identify underpayments, denials, and patient responsibilities, taking appropriate action to resolve discrepancies.
- Managed timely filing of insurance claims, using UB04 claim form, to meet payer deadlines and ensure maximum reimbursement.
- Conduct insurance verification to confirm coverage and eligibility for patients.
- Utilized electronic health records (EHR) systems and billing software
- Managed invoicing processes, ensuring timely and accurate billing to enhance cash flow.
- Collaborated with healthcare providers to obtain necessary documentation for claim submissions.
- Trained and mentored junior staff on best practices in medical billing and coding standards.
- Verified insurance of patients to determine eligibility.
- Filed and updated patient information and medical records.
Desk Adjuster/ CAT Claim Hail/Storm
Pilot Catastrophe
07.2019 - 03.2021
- Review insured submitted evidence to determine coverage decision and write estimate based on document reviewed.
- Reviewing Initial and supplement claims and working closely with insured and contractor.
- Write estimates using Xactimate.
- Worked closely with policy holder, claimant, and selected services to ensure great customer service experience.
- Reviewed the coverage and determined the cause of loss if (Wind/Hail/Fire/Accident) established simple liability and entered detailed fine note.
- Prepared report of findings and negotiated settlement with claim parties.
- Revised case reserves in assigned claims files to cover probable costs.
- Communicate status of claim effectively and often to all parties of the claim.
Education
Bachelor of Science - Insurance And Actuarial Science
Lagos State University
Skills
- Claims processing knowledge
- Accurate data entry
- Adept at utilizing EHR and billing systems
- Familiarity with HIPAA regulations
- Proficient in prioritizing tasks
- Critical thinking capacity
- Effective communication
- Denial management strategies
- Medical terminology fluency
- Appeals process experience
- Teamwork and collaboration
- Adaptability and flexibility
Timeline
Insurance Follow up specialist
Revecore
04.2023 - Current
Accounts Receivable Specialist
Omega Health
04.2021 - 03.2023
Desk Adjuster/ CAT Claim Hail/Storm
Pilot Catastrophe
07.2019 - 03.2021
Bachelor of Science - Insurance And Actuarial Science
Lagos State University
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