Akinsola Akintayo
Fulshear
Summary
Experienced, Innovative, and result driven Insurance claim Analyst with expertise in processing and managing insurance claims in high volumes. Skilled at evaluating documentation, ensuring regulatory compliance, and delivering exceptional customer service. Proven ability to investigate and resolve complex claims with accuracy and efficiency. Strong analytical skills, excellent communication, and a commitment to maintaining high standards in claims processing.
Overview
6
6
years of professional experience
Work History
Insurance claim Analyst
Wipro LLC
Chamblee
07.2024 - 11.2024
- Manage a high volume of claims per week, ensuring timely resolution and client satisfaction.
- Interpret policy coverage and make liability determinations in accordance with guidelines.
- Coordinate with medical providers, adjusters, and legal teams to support accurate evaluations.
- Monitor Insurance claims statuses, identify payment barriers and implement corrective measures to optimize revenue collection processes.
- Analyze claim patterns to identify systemic issues, implementing strategic solutions that streamline reimbursement workflows and enhance revenue capture.
- Resolving complex billing discrepancies through systematic follow up procedures reducing pending claims and accelerating reimbursement cycles.
- Achieved 97% claim accuracy rating and reduced backlog by implementing process improvements.
Claims Associate/Representative
The pharmacy place
Georgia
02.2024 - 07.2024
- Handled end-to-end processing of claims, including data entry, verification, and payout determination.
- Resolved customer disputes and inquiries with empathy and professionalism.
- Assisted with audits and internal reviews to ensure accuracy and integrity of processed claims.
- Improved customer satisfaction score through timely updates and personalized service.
- Monitored quality metrics and compliance standards while maintaining accurate documentation for regulatory requirements and audits.
- Spearheaded process improvements in appointment scheduling that enhanced patient satisfaction and resource utilization.
- Advocated for patient needs through proactive communication with healthcare providers and insurance companies resolving access barriers.
Customer Service Representative
AXA Mansard Health
Nigeria
04.2019 - 03.2023
- Managed customer inquiries and resolved concerns efficiently while maintaining high satisfaction rates through personalized service approach.
- Resolved customer issues/complaints, enhancing satisfaction and loyalty through effective communication.
- Collaborated with team to streamline processes, improving efficiency and service delivery.
- Developed solutions for complex challenges achieving consistent positive feedback.
- Enhanced customer experience by implementing efficient service protocols and building strong relationships with diverse clientele.
- Documented and tracked customer interactions meticulously ensuring accurate follow up and consistent service quality.
- Coordinated with cross functional teams to resolve customer inquiries, ensuring comprehensive problem resolution and client retention.
Education
Master of Business Administration -
Kaduna State University
Kaduna, Kaduna state, Nigeria01.2016
Bachelor of Accounting -
Lagos State University
Ojo, Lagos state, Nigeria01.2002
Skills
- Availity
- Microsoft Office
- Problem-solving
- Communication
- Presentation
- Independent work
- Team Collaboration
- Attention to detail
- Claims Analysis
- Claims Management Systems
- Insurance Policies
- Coverage Review
- Regulatory Compliance
- Customer Communication
- Customer Support
- Process Improvement
- Conflict resolution
- Negotiation
- Relationship management
- Customer Retention
- EPIC
Timeline
Insurance claim Analyst
Wipro LLC
07.2024 - 11.2024
Claims Associate/Representative
The pharmacy place
02.2024 - 07.2024
Customer Service Representative
AXA Mansard Health
04.2019 - 03.2023
Master of Business Administration -
Kaduna State University
Bachelor of Accounting -
Lagos State University
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