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 OrientedStrong attention to details and accuracyMaintaining detailed recordsClaims reviewRevenue collection report preparationAbility to independently identify areas of concern regarding various areas of revenue cycleInsurance follow upHealthcare billing proficiencyCustomer serviceProficient in Microsoft word, Excel and outlook
Medical Billing
Analyzing Claims
Payment Posting
HIPAA Compliance
Financial Counseling
Patient Registration
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