Overview
Work History
Education
Skills
Timeline
Generic

MICHEAL AMANFO

Forth Worth,TX

Overview

6
6
years of professional experience

Work History

AR & Credit Balance Specialist

Aergo Solutions
IRVING, TX
09.2021 - 01.2025
  • Ensures PFS departmental quality and productivity standards are met.
  • Collects and provides patient and payor information to facilitate account resolution.
  • Maintains an active working knowledge of all government-mandated regulations as they pertain to claims submission.
  • Responsible for performing the necessary research in order to determine proper governmental requirements prior to claims submission.
  • Responds to all types of account inquiries through written, verbal, or electronic correspondence.
  • Maintains payor-specific knowledge of insurance, self-pay billing, and follow-up guidelines and regulations for third-party payers.
  • Maintains a working knowledge of all functions within the Revenue Cycle.
  • Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding issues for account resolution.
  • Meets or exceeds customer expectations and requirements, and gains customer trust and respect.
  • Performs refund and credit analyses, audit, and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay, and third-party payors for all patient accounts. Determines if the credit balance is an over-contractual, late charges applied, overpayment, etc. To ensure appropriate actions are taken to resolve.
  • Performs quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits them to the client for approval, signature, and submission.
  • Manage and maintain desk inventory, complete reports, and resolve high-priority and aged inventory. Accurately and thoroughly document the pertinent credit balance review activity performed.
  • Communicate issues to management, including payer, system, or escalated account issues.
  • Handle correspondence received from payers and patients, requesting refunds. Respond timely to emails and telephone messages, as appropriate.
  • Participate in and attend meetings, training seminars, and in-services to develop job knowledge.
  • Other duties, as assigned by management.
  • Ensures PFS departmental quality and productivity standards are met.
  • Collects and provides patient and payor information to facilitate account resolution.
  • Maintains an active working knowledge of all government-mandated regulations as they pertain to claims submission.
  • Responsible for performing the necessary research in order to determine proper governmental requirements prior to claims submission.
  • Responds to all types of account inquiries through written, verbal, or electronic correspondence.
  • Maintains payor-specific knowledge of insurance, self-pay billing, and follow-up guidelines and regulations for third-party payers.
  • Maintains a working knowledge of all functions within the Revenue Cycle.
  • Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding issues for account resolution.
  • Meets or exceeds customer expectations and requirements, and gains customer trust and respect.
  • Compliant with all CHRISTUS Health, payer, and government regulations.
  • Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
  • Appropriately documents the patient accounting host system, or other systems utilized by PFS, in accordance with policy and procedures.
  • Provides continuous updates and information to the PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, and/or payment delays.

Refund Specialist

Christus Health
Irving, TX
10.2018 - 08.2021
  • Performs refund and credit analyses, audit, and reimbursement functions for all Managed Care, Commercial, Medicare, Medicaid, Self-pay, and third-party payors for all patient accounts. Determines if the credit balance is an over-contractual, late charges applied, overpayment, etc. To ensure appropriate actions are taken to resolve.
  • Performs quarterly reviews for Medicare and Medicaid (based on state guidelines) and submits them to the client for approval, signature, and submission.
  • Manage and maintain desk inventory, complete reports, and resolve high-priority and aged inventory. Accurately and thoroughly document the pertinent credit balance review activity performed.
  • Communicate issues to management, including payer, system, or escalated account issues.
  • Handle correspondence received from payers and patients, requesting refunds. Respond timely to emails and telephone messages, as appropriate.
  • Participate in and attend meetings, training seminars, and in-services to develop job knowledge.
  • Other duties, as assigned by management.
  • Research each account using company patient accounting applications and internet resources that are made available.
  • Conducts appropriate account activity on uncollected account balances by contacting third-party payors and/or patients via phone, e-mail, or online.
  • Problem solves issues and creates resolutions that will bring in revenue, eliminating rework.
  • Updates plan IDs, adjusts patient or payor demographic/insurance information, notates the account in detail, identifies payor issues and trends, and solves re-coup issues.
  • Requests additional information from patients, medical records, and other needed documentation upon request from payors.
  • Reviews contracts and identifies billing or coding issues, and requests re-bills, secondary billing, or corrected bills as needed.
  • Takes appropriate action to bring about account resolution in a timely manner, or opens a dispute record to have the account further researched and substantiated for continued collection.
  • Maintains desk inventory to remain current without backlog, while achieving productivity and quality standards.
  • Perform special projects and other duties as needed.
  • Assists with special projects as assigned, documents findings, and communicates results.
  • Recognizes potential delays and trends with payors, such as corrective actions, and responds to avoid A/R aging.
  • Escalate payment delays and problems with aged accounts in a timely manner to the supervisor.
  • Participate in and attend meetings, training seminars, and in-services to develop job knowledge.
  • Respond timely to emails and telephone messages, as appropriate.
  • Ensures compliance with State and Federal Laws, Regulations for Managed Care, and other Third Party Payors.

Education

High School Diploma -

Tony Cheta International School
01-2000

Associate’s Degree - Information Tech

RICHLAND COLLEGE

Skills

  • Strong organizational skills, attention to detail
  • Ability to proficiently use computer and standard office equipment
  • Basic knowledge of
  • FDCPA
  • Basic knowledge of UB-92 and explanation of benefits (EOB) interpretation
  • Ability to proficiently use Microsoft Excel, Outlook, and Word
  • Basic knowledge of CPT and ICD-codes
  • Learns to use professional concepts, and applies company policies and procedures to resolve routine issues
  • General knowledge of accounting principles, pharmacy operations, and medical claims
  • Strong mathematical skills
  • Ability to resolve associate issues effectively and efficiently

Timeline

AR & Credit Balance Specialist

Aergo Solutions
09.2021 - 01.2025

Refund Specialist

Christus Health
10.2018 - 08.2021

Associate’s Degree - Information Tech

RICHLAND COLLEGE

High School Diploma -

Tony Cheta International School

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MICHEAL AMANFO