Sophia Bakare
Dallas
Summary
Highly detail-oriented and results-driven professional with extensive experience in medical billing, coding, and revenue cycle management. Adept at ensuring compliance with industry regulations, streamlining billing processes, and improving collections. Known for strong analytical abilities and exceptional communication skills, both written and verbal, to effectively convey information and resolve issues promptly. Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and experienced with various EMR platforms. Adept at utilizing Practice Management Software, including Epic, Center, Med pointe, Jira Service Desk, and Zendesk, to streamline operations and enhance performance.
Revenue cycle professional with strong background in managing billing, coding, and collections processes. Proven ability to enhance team performance and streamline operations to achieve optimal financial results. Known for effective collaboration, adaptability, and reliability. Skilled in revenue cycle management software, regulatory compliance, and customer service.
Overview
9
9
years of professional experience
Work History
Revenue Cycle Specialist
CRC Group
Dallas, TX
09.2022 - Current
- Reviewed and analyzed providers’ accounts to ensure precise billing and accurate coding practices.
- Collaborated with healthcare teams to educate staff on updates in coding and billing regulations. Efficiently resolve claims by completing appeals or directing materials and accounts to appropriate payers.
- Monitor claim status, research rejections and denials, and document related account activities.
- Identify potential claim and collection issues and implement effective solutions for improvement.
- Accurately review and interpret EOBs to determine denial reasons for specific CPT code.
- Analyze denial reasons on payer portals and apply correct resolutions to secure proper reimbursements.
- Conduct follow-ups on payments from commercial and government payers.
- Take appropriate actions on claims, including submitting appeals, responding to medical record requests, and investigating resolutions for denials.
- Send appeals to the correct payers based on denial reasons to facilitate reimbursement.
- Make outbound calls to insurance companies to verify coverage, eligibility, and claim status.
- Act as a resource for staff inquiries regarding billing and reimbursement issue.
Revenue Cycle Specialist
BC Services
Dallas, TX
12.2019 - 08.2022
- Maintain accurate customer records and update customer account information.
- Analyze customer data and use it to create individualized solutions. Contracted payors to follow up on outstanding claims and ensured timely resolution of account balances.
- Investigated reasons for claim denials and implemented corrective actions, including re-billing claims and adjusting accounts.
- Documented all account activities in system notes to ensure accurate record-keeping and compliance.
- Conducted routine audits of individual accounts to identify and resolve discrepancies in balances.
- Monitored changes in payor requirements and communicated updates to the supervisor and team.
- Maintained positive working relationships with patients, payors, and internal teams to streamline processes.
- Followed up on unpaid claims with third-party payors to ensure timely payment and reduce aging balances.
- Resolved routine payor denials by identifying issues, re-billing claims, and performing necessary account adjustments.
- Provided regular productivity reports to management, highlighting key metrics and improvement opportunities.
- Coordinated with clinical personnel and insurance representatives to address billing issues and expedite claim processing.
Customer Support Rep
UnitedHealth Group
09.2017 - 12.2019
- Handled customer Interactions and inquiries.
- Keep record of customer interactions and actions taken including transactions comments, inquiries and complaints.
- Recommended solutions within customer budgets and proactively follow up with all leads.
- Access electronic and paper cataloging systems to look up product information and availability.
- Remained courageous and calm even during moments of customer dissatisfaction. Addressed customer inquiries and concerns via phone, email, and chat, achieving a customer satisfaction rate of 95%.
- Processed orders, returns, and exchanges efficiently, maintaining accuracy and timeliness.
- Collaborated with cross-functional teams to resolve complex issues, leading to a 20% reduction in customer complaints.
Education
Bachelor of Science - Accounting
Grand Canyon University
Phoenix, AZSkills
- Medical Billing
- Coding Software
- Revenue Cycle Management
- Claim filing
- CMS Guidelines
- Epic
- Athena
- ECW
- Medisoft
- EMR software proficiency
- Data Entry
- Advanced knowledge of Microsoft Excel
- Word
Timeline
Revenue Cycle Specialist
CRC Group
09.2022 - Current
Revenue Cycle Specialist
BC Services
12.2019 - 08.2022
Customer Support Rep
UnitedHealth Group
09.2017 - 12.2019
Bachelor of Science - Accounting
Grand Canyon University