Beatrice Egonmwan
Dallas,TX
Summary
Detail-oriented and empathetic Patient Account Representative with over 5 years of experience in medical billing, insurance claims processing, and patient financial services. Skilled in resolving account discrepancies, verifying insurance coverage, processing payments, and providing exceptional service to patients. Adept at using EHR and billing systems (e.g., Epic, , Meditech, ACE)
Overview
1
1
Certification
5
5
years of professional experience
Work History
Specialist A/R Custom Solution Medicare
Novant Health
06.2024 - 04.2025
- Responsible for all aspects of follow-up and collections, including making telephone calls, accessing pay websites.
- Collects and provides patient and payer information to facilitate account resolution.
- Responsible for performing the necessary research to determine proper governmental requirements prior to claims submission.
- Responds to all types of account inquiries through written, verbal, or electronic correspondence.
- Responsible for professional and effective written and verbal communication with both internal and external customers to resolve outstanding account resolution.
- Collect balances due from payers to ensure proper reimbursement for all services.
- Identifies and forwards proper account denial information to the designated departmental liaison. Dedicates efforts to ensure a proper denial resolution and timely turnaround.
- Demonstrates knowledge of standard bill forms and filing requirements.
- Identify and resolve underpayments with the appropriate follow-up activities within payer timely guidelines.
- Identify and resolve credit balances with the appropriate follow up activities within payer timely guidelines.
- Identify and communicate trends impacting account resolution.
- Identify issues or trends and provide suggestions for resolution.
- Review payer Explanation of Benefits (EOBs) electronic or image as required.
CREDIT BALANCE RESOLUTION SPECIALIST
Conifer Health Solution
11.2019 - 05.2024
- Manage and monitor outstanding accounts receivable to ensure timely collection of payments.
- Review and follow up on insurance claims to resolve denials, rejections, and underpayments.
- Post payments and adjustments accurately to patient accounts in the billing system.
- Communicate with insurance companies, patients, and internal departments to resolve billing issues.
- Maintain documentation for all claim activity in compliance with company and HIPAA standards.
- Ensured compliance with HIPAA and CMS guidelines
- Effectively prioritized tasks to meet tight deadlines while maintaining high quality standards.
- Maintained accurate records and documentation to support compliance and audit requirements.
- Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
- Managed daily accounts receivable operations, ensuring accurate and timely billing.
- Research and resolve claim denials and underpayments by analyzing payer remittance advice (EOBs/ERAs).
- Review payer Explanation of Benefits (EOBs) or electronic image as required.
Education
BSC - Computer Science
Skills
- Strong customer service and excellent written and verbal communication skills
- Proficiency in use of Microsoft Office (Word, Excel, Outlook), Meditech, Epic, Availity, and Finthrive ACE
- Excellent analytical and problem-solving skills
- Ability to relate to customers with varying levels of technical skills and understanding
- Independent logical thinker with analytical skills
- Time management and prioritization skills
- Ability to multitask, prioritize and time manage
- Ability to work autonomously under minimal supervision
- Detail-oriented and demonstrate excellent decision-making skills
- Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
- Experience working with inpatient and outpatient billing requirements
- Experience with Medicare & Medicaid billing processes and regulations preferred
- Knowledge of locating and referencing CMS and/or Medicare Regulations
- Basic knowledge of CPT and ICD-codes
Certification
- Certified Essential of Clinical Research
- Certified Revenue Cycle Management (RCM)
- HIPAA Compliance Training (2025)
Timeline
Specialist A/R Custom Solution Medicare
Novant Health
06.2024 - 04.2025
CREDIT BALANCE RESOLUTION SPECIALIST
Conifer Health Solution
11.2019 - 05.2024