ADEFEMI AGBOLUAJE

Follow up with insurance payers on rejected,denied and unpaid claims.
 Utilize Epic software to analyze,monitor, and manage the revenue cycle

process, ensuring accurate and timely claim resolution.
 Manage account reconciliations related to missing remittance,refunds
required,and any transfer or adjustments needed.
 Post all insurance payments for assigned carriers by CPT code and transfer
outstanding balances to secondary insurance or patient responsibility per
EOB protocol.
 Review claims denied in my work queue to determine quick resolution for
multiple claims.
 Call payers to investigate incorrect denials and get claims reprocessed
correctly.
 Identify and correct billing errors.
 Monitor prior authorization,accuracy of information, and identify
inefficiencies.
 Adhere to HIPAA law regulations,medical law, and ethics regarding billing.
 Efficiently work on special projects as assigned by the supervisor.
 Identify and bill secondary insurances.

Ensure accurate billing and timely submission of electronic and paper claims.
• Investigate and coordinate insurance benefits for insurance claims across
multiple service lines.
• Monitor claim status, research rejections, denials, and document related
account activities.
• Resolve accounts as quickly and accurately as possible, obtaining maximum
reimbursement, and perform investigative activities in fast-paced environments.
• Post adjustments and collections of Medicare, Medicaid, Medicaid Managed
Care, and commercial insurance payers.
• Perform follow-up with Medicare, Medicaid, Medicaid Managed Care, and
Commercial insurance companies on unpaid insurance accounts identified
through aging reports.
• Collect past-due balances and post payments from patients and insurance, also
mail patient statements.

● Perform daily billing department functions such as medical coding, charge entry, claims,
payment posting, and reimbursement management.
● Follow up on new and denied claims with Medicare and HMOs to ensure they are
correctly processed and paid.
● Managing patient accounts and preparing invoices. Ensuring that the patients receive the
accounts.
● Experience navigating state Medicaid, Managed Medicaid, and commercial insurance
portals
● Acquiring and recording medical aid details from patients and liaising with the medical
aid company to obtain authorization on payments owed by patients.
● Following up with patients on late accounts and those that are overdue.
● Following work procedures methodically while ensuring compliance with the rules and
regulations of the hospital or clinic as well as state and federal laws.
● Improving job knowledge and skills by networking and staying abreast of medical service
rates to ensure up-to-date billing.
● Ensuring that patient records, accounts, and payments are meticulously handled.

● Keeping all patient records confidential.
● Uphold and reinforce compliance with hospital policies and federal regulations such as

• Identify, research, resolve, and respond to customer inquiries via telephone and
written correspondence.
• Clarify to customers a variety of specifics pertinent to the organization and healthcare services.
• Explain plan policies, procedures, programs, and guidelines to customers.
• Answer a diverse and high volume of health insurance-related customer calls and correspondence daily.
• Consult and coordinate with various internal departments, external plans,providers, businesses, and government agencies to obtain information and
ensure resolution of customer inquiries.
• Document and record facts related to inquiries and correspondence.
• Verify various insurance plans and eligibility.
• Ensure member satisfaction and provide professional member support.
• Keep proper documentation of each member interaction in the computer system.