Atinuke Iyun
Healthcare Administrator
Elkridge,MD
Overview
17
17
years of professional experience
3
3
years of post-secondary education
Work History
Lead Logistics Support
SOLID ROCK FOURSQUARE
Columbia, Maryland
04.2015 - Current
Lead Logistics Support
Accomplishments:
- Improved Interdepartmental communication which generates 40% more effectiveness
Outsourcing technical support for 25% more efficient outcomes
Responsibilities:
• Human resource management
• Performed needs analysis to determine performance gaps and developed appropriate tactics to resolve issues
• Scheduling and coordinating meetings within the department
• High level management and Ad hoc reporting
• Implementing problem solving skills to maintain focus
• Consistently met organizational and departmental objectives, within budget, and time constraints.
Medical Claims Examiner
Kaiser Permanente
Silver Spring, MD
11.2007 - 09.2017
- Achieved error-free claims adjudication for at least 2 quarters in 4 years
- Created a word document that reduced work time by 40%
- Working knowledge of Federal HMO health policy, OPM/FEHB, MD & VA HMO health policies, Medicare, and MD COBRA Laws & Regulations
- Ensured adherence to HIPAA policy
- Analized members claims for benefits under the ACA health policy
- Analized and adjudicated Professional and specialty claims like Durable Medical Equipment, Physical Therapy, Physiotherapy, Abortion, Vision & case rate claims
- Ensured provider contracts and members’ eligibility status are current
- Analized members’ health policy
- Adjudicated medical claims via TAPESTRY, DIAMOND, KMATE, HEALTHCONNECT, MACESS, and DSPBN systems
- Coordinated benefits according to Medicare and other coordination of benefits (COB) guidelines and policies
- Responded to claims issues reviewed by the Medical Director
- Maintained great working relationship with membership administration, referral, data management departments to ensure accuracy
- Responded to audit inquiries
- Analized members eligibility and providers contracts to determine contract status.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Education
Master of Science - Healthcare Administration
University of Maryland, College Park
College Park, MD 09.2014 - 05.2017
Timeline
Lead Logistics Support
SOLID ROCK FOURSQUARE
04.2015 - Current
Master of Science - Healthcare Administration
University of Maryland, College Park
09.2014 - 05.2017
Medical Claims Examiner
Kaiser Permanente
11.2007 - 09.2017