Motunrayo John
Frisco,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
8
8
years of professional experience
Work History
Revenue Cycle Specialist
Legacy Community Health
11.2021 - 04.2023
- Work 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
- Post adjustment transactions to the collection system as well as the clients system
- Track common claims errors and create solutions
- Perform follow-up actions with insurance companies to ensure timely and full payment
- Utilize account information to assist in write - offs for inclusive CPTs by payor
- Knowledge of commercial, Medicare and Medicaid policies and billing guidelines
- Correct Medicaid claims in electronic billing system for missing or invalid insurance or patient information, according to procedures.
Revenue Cycle Specialist
ACP Billing Services
05.2019 - 11.2021
- Reached out to insurance companies to verify coverage.
- Examines documents for missing information corrects information's needed
- 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.
- Conducted inbound and outbound service calls pertaining to patient management.
- 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 trend's such as denials for specific procedure, diagnosis codes, or other identified issues
Revenue Cycle Specialist
Cornerstone Health Care
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 are 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
Molina Healthcare
07.2015 - 02.2017
- Met customer call guidelines for service levels, handle time and productivity.
- identified researched, resolve 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 provide professional member support.
- Filling grievance and appeal
- Answered a diverse and high volume of health insurance related customer calls and correspondence daily.
- Assist member looking up pcp and provider in network.
Education
Bachelor of Arts - Public Relations And Organizational Communication
RESSUCT UNIVERSITY
SOUTH AFRICA12.2014
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
- Ability to work well others
- Strong attention to detail and accuracy
- Proficient high knowledge in EPIC , Medicaid, Medicare, Marketplace, Business and Commercial account
- Collaborative style and agility, the capacity to adapt to changing priorities and refine strategies after feedback and multi- task to meet deadlines
- Knowledge of basic accounting practices
Timeline
Revenue Cycle Specialist
Legacy Community Health
11.2021 - 04.2023
Revenue Cycle Specialist
ACP Billing Services
05.2019 - 11.2021
Revenue Cycle Specialist
Cornerstone Health Care
04.2017 - 02.2019
Customer Service Representative
Molina Healthcare
07.2015 - 02.2017
Bachelor of Arts - Public Relations And Organizational Communication
RESSUCT UNIVERSITY