Aquila Baffoe
Humble,TX
Summary
Organized Medical Biller boasts 15 plus-year career performing difficult multitasking and claims-processing tasks. Works quickly with insurance companies to resolve problematic disputes and handle patient inquiries. Brings can-do attitude to collaborating with medical professionals, insurance providers and clients to handle invoicing within high-traffic office environment.
Overview
13
13
years of professional experience
Work History
Medical Accounts Receivable Specialist
Medirevv/Tegria RCM
01.2019 - 12.2023
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Input details into accounts and tracked payments.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Handled billing, waivers and claims for private and commercial clients.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Upheld strict quality and accuracy standards through daily process adjustments.
- Verified validity of account discrepancies by obtaining and investigating information from sales, trade promotions, customer service departments and from customers.
- Managed AP and AR operations, coordinating staff workflows and reviewing completed work to reduce errors.
Medical Biller, Accounts Receivable
Providence Health And Services
07.2014 - 01.2019
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Input details into accounts and tracked payments.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Handled billing, waivers and claims for private and commercial clients.
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Performed day-to-day financial transactions, including verifying, classifying, computing, posting and recording accounts receivables' data.
- Facilitated payment of invoices due by sending bill reminders and contacting clients
- Generated financial statements and reports detailing accounts receivable status.
- Upheld strict quality and accuracy standards through daily process adjustments.
- Utilized daily audit information to update aging reports.
- Verified validity of account discrepancies by obtaining and investigating information from sales, trade promotions, customer service departments and from customers.
- Resolved invalid or unauthorized deductions by following pending deductions procedures.
Medical Biller, Accounts Receivable
Care Medical DME
08.2010 - 06.2014
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Submitted appeals using provider portals and phone communication.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Input details into accounts and tracked payments.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Handled billing, waivers and claims for private and commercial clients.
- Facilitated payment of invoices due by sending bill reminders and contacting clients
- Upheld strict quality and accuracy standards through daily process adjustments.
Education
Associate of Science - Health Science
Houston Community College
Houston, TX05.2005
High School Diploma -
Westbury High School
Houston, TX06.2002
Skills
- Investigative research
- Bill processing
- Billing dispute resolution
- Claims processing
- Accounts receivable expertise
- Vendor relationships
- Accounts receivable
Timeline
Medical Accounts Receivable Specialist
Medirevv/Tegria RCM
01.2019 - 12.2023
Medical Biller, Accounts Receivable
Providence Health And Services
07.2014 - 01.2019
Medical Biller, Accounts Receivable
Care Medical DME
08.2010 - 06.2014
Associate of Science - Health Science
Houston Community College
High School Diploma -
Westbury High School
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