Summary
Overview
Work History
Education
Skills
Timeline
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Clement Osafo

The Bronx,NY

Summary

Excellent reputation for resolving problems, improving customer satisfaction, and driving overall operational improvements. Quality-driven with exemplary skills in supervising a talented team and providing required training. Meticulous professional accurately reviewing patient accounts and assisting with issue resolution. Dedicated Reimbursement Specialist with exemplary analyzation and negotiation abilities. Highly skilled in customer service and coverage evaluation.

Overview

19
19
years of professional experience

Work History

Solutions Consultant

JFM Medical Group
03.2017 - Current
  • Interface appropriately with insurance administrators, physicians' offices, patients, and internal personnel.
  • Reimbursement Support Services, Benefit Verifications, Prior Authorizations, Appeals Assistance, and Quality Assurance.
  • Reviewing patient insurance benefit options. Validating prior authorization requirements identifying alternate funding/financial assistance programs
  • Reviewing appropriate billing and coding for products. Assisting with resolving reimbursement issues
  • Educating physician office staff on the use of the client’s patient assistance and reimbursement support services including web-based provider programs. Providing information on relevant reimbursement topics related to client’s products
  • Billing and Coding Support; Patient Assistance and Drug Replacement. Assistance in locating coverage for uninsured and underinsured patients, Free Drug Programs,
  • Responsible for driving accuracy and quality assurance, compliance with all established policies and procedures, and sound documentation for all activities.
  • Operated with high integrity, built trust, and earned sustained credibility with internal and external clientele
  • Checks quality cases built by other associates to ensure the highest level of quality.
  • Buy and Bill Reimbursement Support


Revenue Cycle Specialist

New York Health And Hospitals
09.2006 - 02.2017
  • Ensure the program is operating according to contractual obligation by providing day-to-day guidance to team members, monitoring compliance with program policies and procedures, and turn-around times, and ensuring adherence to quality expectations
  • Working with team management to drive team productivity and support performance monitoring
  • Monitored and Audit team productivity at 100% Subject Matter Expert on making sure all team SOP are current and implemented
  • Design training for the team; seek ways to improve the training/onboarding process; identify mentors for new hires
  • Facilitated new hire training sessions for the annual open enrollment project.
  • Manage the resolution of client issues and ensure appropriate follow-up is done to manage client relationships; Deliver routine client reports
  • Improved cash flow with diligent follow-up on pending claims and appeals processes.
  • Developed and implemented policies and procedures to maintain compliance with industry regulations and standards.
  • Identified and resolved process issues to encourage smoother procedures, more efficient workflow, and overall business growth.

Senior Associate

Citizen Advisory Bureau
05.2005 - 05.2006
  • Interface appropriately with insurance administrators, physicians' offices, patients, and internal personnel. Reimbursement Support Services, Benefit Verifications, Prior Authorizations, Appeals Assistance
  • Observed strict procedures to maintain data and plan participant confidentiality.
  • Trained new team members in policies and procedures and offered insight into the best ways to manage job tasks and duties.
  • Explained benefits to plan participants in easy-to-understand terms in order to educate each on available options.
  • Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
  • Assistance in locating coverage for uninsured and underinsured patients, Free Drug Program, and foundations.
  • Increased client satisfaction through thorough analysis of project requirements and delivering high-quality results.

Education

Bachelor of Science - Business Administration

Kutztown University of Pennsylvania
Kutztown, PA

Skills

  • Disease specialization proficiency Healthcare billing proficiency
  • Strong medical ethic Problem resolution ability
  • Oncology, Immunology, Hematology, and Urology Support
  • Medicare Part A, B, C, D, and Commercial payer knowledge
  • Specialty Pharmacy process and provider support
  • Hub Management and collaboration on reimbursement level
  • Self-motivated
  • Process implementation
  • Team liaison
  • Claims investigation and research
  • Specialty Pharmacy Billing
  • Effective communication skill
  • Relationship building
  • Stakeholder relations
  • Client account management
  • Chronic disease management
  • Strong written and verbal communication skills
  • Works well independently
  • Effective at multi-tasking
  • Budget administration
  • Team building skills
  • Understanding of miscellaneous J-Code and Q-code billing
  • Buy and Bill experience in all healthcare settings
  • Territory Management (Multiple State Coverage on a six-week rotation)
  • Self Starter, seeker of solutions, and answers
  • Culture-focused and dedication

Timeline

Solutions Consultant

JFM Medical Group
03.2017 - Current

Revenue Cycle Specialist

New York Health And Hospitals
09.2006 - 02.2017

Senior Associate

Citizen Advisory Bureau
05.2005 - 05.2006

Bachelor of Science - Business Administration

Kutztown University of Pennsylvania

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Clement Osafo