Matilda Oyewo
Mckinney,TX
Summary
A Revenue Cycle Specialist with over 5 years of experience in multiple roles across Client Servicing, Operations Management, Revenue Enhancement , Quality Assurance and Team Management. A smart working professional with sound coordination, capable of delivering desired results.
Overview
10
10
years of professional experience
Work History
Revenue Cycle Specialist
Faith Foundation
Houston, TX
11.2021 - 05.2025
- Worked closely with department heads to ensure claims information is being submitted accurately and timely. Monitored market trends and news to identify emerging opportunities.
- Monitor unpaid claims , also making corrections as needed.
- Performed appeal insurance claim denials, underpayments, and understanding root cause analysis of insurance related activities.
- Researched the denied claims to determine reason for denial by contacting the payor and reviewing the EOB or R&S.
- Process pediatric facilities and DRG reimbursement.
- Resolved system billing and claim WQ edits by working closely with Clinical departments, coding staff and registration to assure errors are completed correctly and in a timely manner.
- Track common claims errors, identify and report inaccurate reimbursement and contractual trends.
- Perform follow-up actions and documents follow -up activities, conversation with payors and guarantors
- Utilize account information to assist in write - offs for inclusive CPTs by payor.
- Process Hospital Revenue Cycle and Insurance Collections in commercial payers (BCBS, AETNA, UHC) and government entities (Traditional Medicaid and Managed Medicaid Plans.
- Correct Medicaid claims in the electronic billing system for missing or invalid insurance or patient information, according to procedures.
- Ensure accurate billing and timely submission of electronic and paper claims.
- Investigate and coordinate insurance benefits for insurance claims across multiple service lines.
- Monitor claim status, research rejections, denials, and document related account activities.
- Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement, and perform investigative activities in fast-paced environments.
- Post adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers.
- Perform follow-up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports.
Revenue Cycle Specialist
ACP Billing Services
Orlando, FL
05.2019 - 11.2021
- Reached out to insurance companies to verify coverage.
- Analyzed Commercial account and Hospital RC and collection.
- Examines documents for missing information and corrects information needed.
- Report appeals to Manager to review if there is a strong supporting argument that it should be escalated at payor level.
- Sets follow -up activities based on status of the claim.
- Identified and billed secondary insurances.
- Engaged in reading RA/EOBs and post payment accurately with great attention to detail.
- Conducted inbound and outbound service calls pertaining to patient management. Report problems in detail and refer to the Manager with recommendation of action needed and continual follow-up.
- Daily communication with insurance companies and other commercial insurers to address coordination of benefit and claims resolution.
- Contact the patient when necessary to obtain correct information to resolve the issue for a prompt payment. Communicated identified payer trends such as denials for specific procedure, diagnosis codes, or other identified issues.
- Sets follow - up activities based on status of the claim.
- Identified and billed secondary insurances Engaged in a reading RA/EOBs and post payment accurately with great attention to detail.
- Daily communication with insurance companies and other commercial insurers to address coordination of benefit and claims resolution
- Contact patient when necessary to obtain correct information to resolve issue for a prompt payment
- Communicated identified payer trends such as denials for specific procedure, diagnosis codes, or other identified issues.
- Conducted inbound and outbound service calls pertaining to patient management.
Revenue Cycle Specialist
Cornerstone Health Care
Houston, TX
04.2017 - 02.2019
- Identified and resolved payment issues between patients and providers.
- Reviewed EOBs for correct payment, deductible , adjustment and denials
- Reconcile commercial and government account, ensured CPT and diagnostic codes are accurate
- Identified and report trends in carrier payments and denials which includes documentation of actions taken to resolve issues.
- Analyzed claims and ensured all pertinent information is organized and prepared to assist with efficient processing.
- Collected payment for outstanding claims and ensure payments received are reconciled correctly
- Identified billing errors, short payments , overpayments and unpaid claims and resolved them accordingly
- Observed legal and ethical guidelines of HIPAA for safeguarding patient and company confidential and proprietary information.
Customer Service Representative
Brookville healthcare
Odessa, TX
07.2015 - 02.2017
- Met customer call guidelines for service levels, handle time and productivity.
- Identified, researched, resolved and responded to customer's inquiries via telephone and written correspondence.
- Provide technical and customer service support by clarifying the customer's request, assessing the situation, selecting and explaining the most effective solution.
- Adhered HIPAA regulations daily
- Ensured member satisfaction and provided professional member support.
- Filing grievance and appeal
- Answered a diverse and high volume of health insurance related customer calls and correspondence daily.
- Assist members looking up pcp and providers in the network.
Education
Bachelor of Arts - Business Administration, Project Management
AMERICAN INTERCONTINENTAL UNIVERSITY
SCHAUMBURG, ILLINOIS04.2020
Skills
- Claims Review
- Medical Billing
- Insurance Follow up
- Experience with payment posting
- Ability to independently identify areas of concern regarding various areas of revenue cycle Hospital billing / UB04
- Ability to work well with others
- Detail Oriented
- Strong attention to detail and accuracy
Timeline
Revenue Cycle Specialist
Faith Foundation
11.2021 - 05.2025
Revenue Cycle Specialist
ACP Billing Services
05.2019 - 11.2021
Revenue Cycle Specialist
Cornerstone Health Care
04.2017 - 02.2019
Customer Service Representative
Brookville healthcare
07.2015 - 02.2017
Bachelor of Arts - Business Administration, Project Management
AMERICAN INTERCONTINENTAL UNIVERSITY