OLAWUNMI AJANAKU
Dallas,TX
Summary
Methodical Revenue Cycle Specialist with strong attention to detail and in-depth understanding of billing procedures. Excellent planning and problem-solving abilities. Prepared to bring five years of related experience to a dynamic position with room for career growth.
Overview
7
7
years of professional experience
4
4
years of post-secondary education
Work History
Revenue Cycle Specialist
Allstate Health Solution
Dallas , TX
04.2022 - 01.2024
- Resolved complex payment issues such as denial, underpayments or incorrect coding usually four transactions every one hour.
- Correct Medicaid claims in electronic billing system for missing or invalid Insurance, or patient information according to procedures
- Reached out to insurance companies to verify coverage
- Monitor claim status, research rejections, denials, and document related account activities.
- Contacted insurance providers to check patient coverage
- Determine most efficient process to resolve refund requests or credit balance Identified and billed secondary insurances engaged in reading RA/EOBs and post payment accurately with great attention to detail
- Recognizes potential issues within claims and collections process and recommends and implements solutions for improvement
- Research missing payments and secure documents needed for posting
- Track common claims errors, identify and reports inaccurate reimbursement and contractual trends
- Identified billing errors, short payments, overpayments and unpaid claims and resolved them accordingly
- Identified and resolved payment issues between patients and providers.
- Reached out to insurance companies to verify coverage.
- Orchestrated client-centered financial packages factoring in current market trends.
- Improved emergency resolution processes by 10% to save time.
Revenue Cycle Specialist
United Healthcare
Dallas, TX
05.2020 - 04.2022
- Resolve claim edits within practice management billing system to ensure successful claim submission
- Daily communication with insurance companies and other commercial insurers to address coordination of benefits and claims resolution
- Reviewed EOBs for correct payment, deductible, adjustments and denials
- Sets follow-up activities based on status of claim
- Generated receivables report and offered improvement recommendations
- Reached out to insurance companies to verify coverage
- Work and manage claims from all aging buckets including posting and appeals
- Ability to multitask and prioritize tasks to accomplish and maintain goals
- Effectively navigate and utilize various healthcare provider software systems
- Ensures compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards
- Resolve healthcare claims through verbal or online inquiries to health insurance payers usually four claims within one hour.
- Verify accuracy of insurance and patient information
- Verify insurance data entry along with scheduling and confirming appointments
- Post adjustments and collections of Medicare, Medicaid, Medicaid managed care and commercial insurance payers
- Read and interpret insurance Explanations of Benefits (EOB)/Remittance Advice (RA) with understanding and take appropriate steps to resolve issues.
- Balanced and reconciled accounts.
- Identified and resolved payment issues between patients and providers.
- Managed over 50 customer calls per day.
Revenue Cycle Specialist
Cigna Healthcare
Dallas, TX
06.2018 - 04.2020
- Identified and resolved payment issues between patients and providers
- Resolved system billing and claim WQ edits by working closely with clinical departments, coding staff and registration to assure errors are competed correctly and in timely manner
- Utilize account information to assist in write-offs for inclusive CPTS by payor
- Communication with insurance payers to ensure proper coverage for patients or to ensure timely and accurate reimbursement for services rendered
- Work with payor throughout resolution process.
- Investigate and coordinate insurance benefits for insurance claims across multiple service lines
- Review and interpret payment information from EOB (explanation of benefits) to accurately apply payment and adjustment when necessary
- Research denied claims to determine reason for denial by contacting the payor and reviewing the EOBS or R&S.
- Generated receivables reports and offered improvement recommendations.
- Helped clients make optimal decisions on amounts and timing of capitalization.
Customer Service Representative
Meritain Health
Dallas, TX
02.2017 - 05.2018
- Effectively handled inbound and outbound calls on 401k participants
- Accurately and successfully process service transactions and reached resolution on member issues in timely and effective manner
- Ability to effectively establish rapport, communicate information and diplomatically respond to inquiries from callers
- Ability to multi-tasks including navigating between computer applications while speaking with participants on phone
- Tactically handles confrontational or stressful interactions with customers
- Handled customer inquiries and suggestions courteously and professionally
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
- Provided primary customer support to internal and external customers.
- Responded to customer requests for products, services, and company information
Education
Bachelor of science - Business Administration
University of Lagos
Nigeria 09.2012 - 07.2016
Skills
Detail Orientedundefined
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
If you really look closely, most overnight successes took a long time.
Steve Jobs
Timeline
Revenue Cycle Specialist
Allstate Health Solution
04.2022 - 01.2024
Revenue Cycle Specialist
United Healthcare
05.2020 - 04.2022
Revenue Cycle Specialist
Cigna Healthcare
06.2018 - 04.2020
Customer Service Representative
Meritain Health
02.2017 - 05.2018
Bachelor of science - Business Administration
University of Lagos
09.2012 - 07.2016
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