Calenkwa Kwofie
Carrollton,TX
Summary
Dedicated billing professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Achieved goals regarding error-free work, transactions, process and compliance requirements. Complied and enforced all policies and procedures related to position, department and company.
Overview
16
16
years of professional experience
Work History
RCM MEDICAL BILLING SPECIALIST
ALLSCRIPTS
Dallas, TX
02.2019 - 11.2025
- Answered phone calls from insurances and patients; responded promptly and followed up all interactions and questions for information, both internal and externally
- Precisely completed appropriate claims paperwork, documentation and system entry; ran, reviewed and worked unpaid patient balance reports for payment by reading current notes and place for past due letters and phone calls
- Posted and adjusted payments from insurance companies; reviewed and worked all unpaid and denied insurance correspondence
- Evaluated patients' financial status and established appropriate payment plans; prepared and send uncollected patient payments to collections.
- Evaluated patients' financial status and established appropriate payment plans; prepared and send uncollected patient payments to collections.
- Actively listened and interpreted EOB's denial reasoning, processed credit card payment, and located missing payments
- Prepared and researched billing statements for patients and verified correct diagnostic coding for discrepancies for compliance and reimbursement accuracy; prepared insurance/patient correspondence for coworkers by reviewing and batching for further attention and review
- Actively maintained CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing
- Resolved problems, improved operations and provided exceptional service
OPERATIONS FUNDING REPRESENTATIVE
WILLIS TOWERS WATSON
Dallas, TX
07.2018 - 07.2019
- Managed over 100 customer calls per day and resolved health benefits questions for employees of client companies
- Verified insurance of employees with carriers, clients and third party administrators
- Processed checks, imitated stop payments and voids, collected overpayments
- Reviewed claim submissions ensuring accuracy according to Medicare processing guidelines
- Entered claim adjustments into system for adjudication
MEDICAL OFFICE ASSISTANT
WOMEN'S HEALTH CENTER
Dallas, TX
11.2017 - 05.2018
- Answered and directed 80-100 telephone calls daily
- Routed messages to Physicians or Lab Technicians for review
- Reviewed files, records, and other documents to obtain information in response to requests
- Scanned, edited and faxed medical correspondence
- Uploaded medical records to Practice Fusion, electronic health records (EHR) software
- Assisted daily in assigning medical diagnostic codes for billing
- Verified Medical Insurance eligibility, collected co-pays and other out of pocket costs.
CUSTOMER SERVICE ADVOCATE
UNITED HEALTH GROUP
Richardson, TX
11.2016 - 04.2017
- Processed over 100 pharmacy claims daily, verified eligibility and payment requirements
- Entered claim payments, reserves and new claims on computer system
- Verified and analyzed data used in settling claims to ensure accuracy and compliance
- Assisted patients with financial or medical questions
CERTIFIED MEDICAL ASSISTANT
LINDAN PARK REHABILITATION CENTER
Richardson, TX
07.2014 - 07.2015
- Coordinated utilization review of managed care contracts
- Maintained and submitted over 80 daily registration logs
- Collaborated with members of multidisciplinary health care teams to plan, manage, or assess patient treatments
- Organized records of departmental day-to-day clinical activities.
CERTIFIED MEDICAL ASSISTANT
GOLDEN LIVING REHABILITATION CENTER
Greensboro, NC
12.2012 - 05.2014
- Resolved over patient complaints and answered patients' questions regarding policies and procedures
- Maintained over 70 patient charts for Business Office and Medical Records
- Scheduled appointments for patients
- Greeted and logged in patients arriving at office or clinic
- Contacted medical facilities or departments to schedule patients for tests or admission.
GROUP HOME MANAGER
COMMUNITY ALTERNATIVES
Greensboro, NC
09.2009 - 03.2011
- Maintained residents' medication and medical supplies
- Supervised and increased direct care staff
- Maintained client records in accordance with regulatory standards
- Assisted with legal, licensing and regulatory certification activities as needed
- Oversaw Medicaid administration for hospital admissions
- Coordinated over 50 referrals and linkages with community agencies
Education
Bachelor of Arts - (Interdisciplinary/Health Studies)
North Carolina A & T State University
Greensboro, NC01-2019
Certification - Medical Assisting
Guilford Technical Community College
Greensboro, NC01-2010
Skills
- Billing statement review
- Payment posting
- Customer service
- Accounts receivable
- Proficiency in Microsoft
- Insurance Verification
- Medical claims
- Medicaid and Medicare process
- Medical terminology
- CPT Coding
- EMR Systems- Epic, Allscripts PM, Laserfiche
Additional Information
- Authorized to work in the US for any employer
Timeline
RCM MEDICAL BILLING SPECIALIST
ALLSCRIPTS
02.2019 - 11.2025
OPERATIONS FUNDING REPRESENTATIVE
WILLIS TOWERS WATSON
07.2018 - 07.2019
MEDICAL OFFICE ASSISTANT
WOMEN'S HEALTH CENTER
11.2017 - 05.2018
CUSTOMER SERVICE ADVOCATE
UNITED HEALTH GROUP
11.2016 - 04.2017
CERTIFIED MEDICAL ASSISTANT
LINDAN PARK REHABILITATION CENTER
07.2014 - 07.2015
CERTIFIED MEDICAL ASSISTANT
GOLDEN LIVING REHABILITATION CENTER
12.2012 - 05.2014
GROUP HOME MANAGER
COMMUNITY ALTERNATIVES
09.2009 - 03.2011
Bachelor of Arts - (Interdisciplinary/Health Studies)
North Carolina A & T State University
Certification - Medical Assisting
Guilford Technical Community College