Faith Onyebuagu
Houston,Texas
Summary
Detail-oriented Claims Specialist with strong experience in insurance claims investigation, denial resolution, and payer communication. Proven ability to manage complex claims, analyze documentation, and drive timely claim resolution in high-volume environments. Skilled in navigating payer systems, researching coverage issues, and maintaining accurate claim records. Adept at working independently, mediating between stakeholders, and ensuring compliance with regulatory and procedural standards. Prepared to transition expertise into Workers’ Compensation claims handling, including lost time and litigated claims.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Revenue Cycle Claims Specialist
Natera, Inc.
Remote
01.2024 - Current
- Investigate and resolve complex insurance claims by reviewing documentation, payer requirements, and claim history.
- Manage full claim lifecycle including submission, follow-up, appeals, and final resolution.
- Analyze claim denials and develop effective appeal strategies, improving overturn rates by 30%.
- Communicate with payers, patients, and internal teams to gather claim information and ensure timely processing.
- Maintain accurate claim records in system, ensuring compliance with regulatory and company standards.
- Research coverage issues and resolve discrepancies impacting claim adjudication.
Revenue Cycle Specialist
Cencora (AmerisourceBergen)
Remote
01.2023 - 01.2024
- Processed and resolved over high-volume claims, including denied and rejected claims requiring detailed investigation.
- Reviewed EOBs, payer responses, and documentation to determine appropriate next steps for claim resolution.
- Coordinated with insurance companies and providers to obtain missing information and clarify coverage.
- Supported appeals process by compiling documentation and submitting reconsiderations.
- Maintained detailed and accurate claim records throughout the lifecycle.
Data Quality Reviewer
Tapestry Health
Remote
01.2021 - 01.2023
- Supported claims accuracy by ensuring proper documentation for billing and reimbursement.
- Collaborated with clinical and billing teams to resolve discrepancies affecting claims processing.
- Communicated with patients and providers to ensure accurate data collection and compliance.
- Monitored and escalated issues requiring intervention, demonstrating strong decision-making and independent judgment.
- Assisted in maintaining compliance with payer guidelines and healthcare regulations.
Education
B.Sc. - Business Administration
Enugu State University of Science and Technology
Skills
- Workers’ Compensation Claims Handling (Transferable Skills)
- Claims Investigation & Resolution
- Denial Management & Appeals Processing
- Coverage Review & Issue Research
- Payer & Stakeholder Communication
- Claims Documentation & Data Accuracy
- EHR & Claims Systems (Epic, Availity, AdvancedMD, TMHP, LIMS)
- HIPAA Compliance & Regulatory Standards
- Indemnity & Medical Claims Understanding
- Conflict Resolution & Mediation
- Microsoft Excel (Reporting, Data Analysis)
Certification
- ITIL 4 Foundation
- HIPAA Compliance Certification
- Microsoft Office Specialist
Professional Development
- Ongoing training in Revenue Cycle Management and claims processing
- Active participation in payer and compliance workshops
- Currently pursuing Dual Master’s Degree (MBA & MHA)
Timeline
Revenue Cycle Claims Specialist
Natera, Inc.
01.2024 - Current
Revenue Cycle Specialist
Cencora (AmerisourceBergen)
01.2023 - 01.2024
Data Quality Reviewer
Tapestry Health
01.2021 - 01.2023
B.Sc. - Business Administration
Enugu State University of Science and Technology