Kafui Dotche-Dekpe
Houston,TX
Summary
Highly motivated and results-oriented Senior Analyst with over 14 years of progressive experience in finance, reporting, billing, revenue cycle, Managed Care, policy and procedure in the healthcare industry. Collaborate cross-functionally across organizational levels to achieve the highest standards of company goals and expectations.
Overview
15
15
years of professional experience
Work History
Senior Analyst - Payer Analytics
City of Hope
Houston, TX
07.2022 - Current
- Analyze data trends to inform operational strategies and enhance decision-making processes.
- Collaborate with payer relations team on analytic design,interpretation, streaming workflows, improving interdepartmental communication and efficiency.
- Collaborate with payer relations team on analytic design,
interpretation, streaming workflows, improving interdepartmental communication and efficiency. - Understand Medicare and commercial reimbursement, policies, and regulatory requirements and apply to building contract, modeling, insights, and new ideas.
- Serve as an expert on payer contract financial terms and modeling.
- Identify, interpret, and make recommendations regarding unclear contract or proposed contract terms.
- Analyzed automated pricing and reporting processes, designing edits that improved accuracy and outcomes.
- Ensure proper and timely loading of moderate to complex insurance contracts into EPIC software.
- Investigated payment variances related to contract non-compliance to identify underlying issues.
- Work with manager to efficiently merge data from multiple databases and find efficient ways to complete reporting.
Senior Managed Care Contract Analyst
Allegheny Health Network
Pittsburgh, Pennsylvania
03.2020 - 07.2022
- Provided analytical support for the preparation of business plans and negotiation process of managed care contracts.
- Built, loaded, and maintained hospital, professional, and
ASC contracts in Epic. - Performed reimbursement impact analyses and ensured data quality and consistency.
- Collaborated with Revenue Cycle and Finance
Teams on contract building and analysis requests. - Performed reimbursement impact analyses and
ensured data quality and consistency. - Provided analytical support for the preparation of
business plans and negotiation process of
managed care contracts. - Responsible for creating and analyzing standard
and Adhoc reports to measure and identify
revenue opportunities from payers. - Managed underpayment AR for assigned payors
including successfully recovering on underpaid
accounts. - Conceptualized ideas for and verified output of AI-automated Epic reports.
- Oversaw new analysts' work on contracts build in EPIC, reimbursement analyses,contract compliance and payment variance.
Reimbursement Analyst
Visiting Nurse Health System
Atlanta, GA
04.2017 - 03.2020
- Created, reviewed, and analyzed all billing and
collection reports to identify errors and payer
trends. - Analyzed all reimbursement, contractual and
transfer adjustment. - Developed and participated in the negotiation of
reimbursement rates with new payers, out of
network payers and new affiliated providers. - Interacted with major medical insurances and
patients to ensure proper payment of claims and
accuracy of rate per contract. - Followed up on submitted claims, monitored
unpaid claims and initiated appeals as
necessary. - Collaborated with revenue cycle management
to suggest submission corrections and exceeded
annual goal.
Lead Office Assistant
Memorial Hermann Health System
Houston, TX
07.2014 - 03.2017
- Monitored department budgets and managed timelines to ensure compliance with financial guidelines.
- Identified favorable and unfavorable trends and
communicated results to finance team - Assisted patients in understanding their charges and responsibilities, set payment plans, collections, and A/R productivity
- Assisted in month-end closing procedures by compiling financial data and reports.
- Oriented and trained employees on system and hospital policies to enhance understanding and compliance.
Administrative Office Assistant II
Memorial Hermann Health System
Houston, TX
06.2011 - 07.2014
- Coordinated scheduling and office activities to support operational efficiency.
- Investigated and corrected invoice discrepancies to ensure accurate billing.
- Performed insurance verification, authorization
and billing duties. - Maintained hospital reimbursement and payment
reports for all managed care payers. - Liaison between patients, contract
vendors/payers, physicians, and other healthcare
providers.
Education
Bachelor of Science - Healthcare Administration
University of Houston-Clear Lake
Houston, TX12-2014
Certification Course - Health Information Technology- Billing and Coding
Houston Community College
Houston, TX12-2011
Bachelor of Business Administration - undefined
Pittsburg State University
Pittsburg, KS12-2009
Certified Resolute HB & PB Billing Reimbursement -
EPIC
EPIC 05.2001 -
Skills
Payer strategy
EPIC reimbursement
Contract negotiation/Build
Claims processing
Reimbursement process
Revenue reporting
Data interpretation
Business Analysis (Analytical Skills)
Microsoft Office proficiency
Tableau, SQL
Critical thinking
Client and team-oriented work ethic
Timeline
Senior Analyst - Payer Analytics
City of Hope
07.2022 - Current
Senior Managed Care Contract Analyst
Allegheny Health Network
03.2020 - 07.2022
Reimbursement Analyst
Visiting Nurse Health System
04.2017 - 03.2020
Lead Office Assistant
Memorial Hermann Health System
07.2014 - 03.2017
Administrative Office Assistant II
Memorial Hermann Health System
06.2011 - 07.2014
Certified Resolute HB & PB Billing Reimbursement -
EPIC
05.2001 -
Bachelor of Business Administration - undefined
Pittsburg State University
Certification Course - Health Information Technology- Billing and Coding
Houston Community College
Bachelor of Science - Healthcare Administration
University of Houston-Clear Lake