Babacar Diop
Columbus,OH
Summary
Experienced with Epic systems, ensuring efficient and user-friendly interfaces. Utilizes problem-solving skills to address and resolve system issues promptly. Track record of enhancing clinical workflows through effective system configurations and support.
Overview
5
5
years of professional experience
1
1
Certification
Work History
HB Claims Analyst
10K Consulting
05.2024 - 01.2025
- Submitting and reviewing hospital claims for accuracy using the Epic system
- Ensuring that all necessary patient and insurance information is correct before submission
- Monitoring claims to ensure timely reimbursement and resolution
- Following up with insurance companies on denied or underpaid claims
- Working with payers and internal departments to resolve discrepancies
- Analyzing claim denials and determining the cause (e.g., coding issues, authorization errors, etc.)
- Correcting errors and resubmitting claims
- Working with the coding team to ensure accurate coding for claims
- Verifying insurance eligibility and benefits for patients to ensure coverage before services are provided
- Updating insurance information in the Epic system as needed
- Collaborating with the coding department to ensure proper coding of hospital services for accurate claim submission
- Reviewing and correcting billing errors related to codes or modifiers
HB Claims Analyst
Bridgeport Hospital
09.2023 - 03.2024
- Accurate Data Entry: Ensure that all patient information, procedure codes, and insurance details are entered accurately into the billing system to avoid claim denials and delays
- Timely Submission: Submit claims promptly to insurance companies to expedite reimbursement and minimize the risk of late payments or denials
- Compliance with Regulations: Adhere to all relevant healthcare regulations, such as HIPAA and CMS guidelines, to maintain compliance and avoid penalties
- Verification of Benefits: Verify patient insurance coverage and benefits eligibility prior to providing services to ensure accurate billing and reduce claim rejections
- Claims Scrubbing: Implement a claim scrubbing process to identify and correct errors or inconsistencies in claims data before submission, reducing the likelihood of denials
- Follow-Up on Outstanding Claims: Regularly follow up on outstanding claims to identify and address any issues preventing reimbursement, such as missing information or denied claims
- Electronic Remittance Advice (ERA) Reconciliation: Reconcile electronic remittance advice (ERA) with billing records to ensure accurate payment posting and identify any discrepancies that require resolution
- Appeals Management: Develop a systematic approach for managing claim denials and appeals, including documentation of appeals and communication with payers to resolve disputes
- Provider Education: Provide ongoing education and training to billing staff on coding updates, billing guidelines, and payer requirements to ensure consistent and accurate billing practices
- Continuous Improvement: Continuously evaluate and refine billing processes to identify opportunities for efficiency gains, cost savings, and revenue optimization
- Manage patient records, schedule appointments, document care, and coordinate treatment plans for patients receiving ambulatory care
- Assign beds and build departments
HB Charging Analyst
Grant Medical Center
02.2020 - 07.2023
- Setup Charging workflows, CDM maintenance and Charge Router build
- Set up the Cost Center Assignment Tables, Cost Center Department Selection Table, and complex Charge Router build to ensure correct revenue routing
- Inherited a static CDM from a legacy system with 50,000+ charge lines and converted it into a consolidated Epic CDM with only 3,000 charge lines by using Excel
- Delivered application testing, charge testing, integrated testing, and parallel revenue cycle testing phases of the project for the Resolute Billing applications
- Identified and provided test and contract build audits to leadership
- Gathered necessary information from SMEs to build Epic’s general ledger table and create general ledger patterns in the HLB Masterfile
- Using the Reporting Workbench framework; automated file exports and imports via the Batch Scheduler
- Worked with Contract Management team to extract contract inventory from legacy systems and use data to populate Epic’s Contract Matrix tool
- Utilized Epic’s Contract Matrix tool to appropriately scope the volume of contract build
- Created necessary components, extensions and fee schedules for Expected Reimbursement Contracts build
Education
Bachelor - finance
CHEIKH ANTA DIOP UNIVERSITY
Dakar06.2013
Certification
EPIC CERTIFICATION, Resolute Hospital Billing Administration, Resolute Hospital billing Claims and Electronic Remittance Administration
Languages
French
Native or Bilingual
Timeline
HB Claims Analyst
10K Consulting
05.2024 - 01.2025
HB Claims Analyst
Bridgeport Hospital
09.2023 - 03.2024
HB Charging Analyst
Grant Medical Center
02.2020 - 07.2023
Bachelor - finance
CHEIKH ANTA DIOP UNIVERSITY
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