Oluwadamilola Ibrahim
Houston
Summary
Detail-oriented Revenue Cycle Specialist with 2years of experience managing medical insurance claims. Investigates and resolve insurance company disputes and communicate with the patient regarding account balances and claim statuses. Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
4
4
years of professional experience
Work History
Insurance Representative II
PFS Group
06.2024 - 09.2024
- Followed up with insurance companies to resolve unpaid or denied claims.
- Ensured timely submission of claims to various insurance carriers
- Responsible for following up with various insurance company.
- Assist with filing an appeal
- Generated leads through cold-calling, networking and other outreach methods.
- Analyzed customer needs to provide customized insurance solutions.
- Educated clients on insurance policies and procedures.
- Strong customer service experience demonstrating compassion and concern
- Able to communicate effectively both oral and written and good interpersonal skills
- Ability to work well under pressure and multi-task routinely
- Professional presentation/appearance/demeanor
- Demonstrated stable work history
- HIPAA knowledge
- Knowledge of Medicare and Medicaid regulations and other insurance guidelines preferred
- Ability to work well under pressure and multi-task routinely
- Ability to analyze, audit and reconcile accounts
- Knowledgeable in all aspects of insurance reimbursement
- Supervised insurance claims for equitable resolutions on behalf of both client and insurer.
- Maximized policyholder satisfaction by efficiently handling claims and providing timely resolutions.
- Kept detailed records on individual insurance claims and incorporated into detailed client files.
Revenue Cycle Specialist
Athenahealth
01.2024 - 05.2024
- Understanding and staying informed of the changes with procedures, billing guidelines, and laws for specific insurance carriers or payers.
- Submitted appeals and reconsiderations on claim rejections, underpayments, and denials.
- Communicated identified payer trends such as denials for specific procedures, diagnosis codes, or other identified issues.
- Reviewing and verifying patient demographics and insurance varification for accuracy.
- Demonstrating flexibility to perform other tasks as needed in an active work environment.
- Resolve discrepancies between insurance companies and providers.
- Research, appeal, and resolve unpaid claims
- Document all collections activity performed on each account in the system.
Revenue Cycle Specialist
Providence Health
12.2022 - 12.2023
- Verified eligibility and document verification.
- Maintained patient records which include detailed patient treatments and diagnoses as well as updating payment and medical insurance information.
- Communicated with medical insurance providers to verify patient eligibility.
- Identified medical coding mistakes, as well as patient underpayments or overpayments, and rectified them accordingly.
- Assist client with arrangement for payment.
- Monitored billing errors and timely re-bills.
- Responsible for following billing and collection rules
- Reviewed patient deductible and/or copays and enter information into NextGen, provide front of patient responsibilities.
- Provided answers to patients, clerical staff, and insurance companies.
- Bill patients for clinical services rendered.
Medical Billing Specialist
Reddington Hospital
01.2021 - 12.2021
- Accurate determination of balances/deductible owed prior to patients' appointments
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Insurance and procedure verification
- Posted and adjusted payments from insurance companies.
- Diligence and detailed work to collect on outstanding claims
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Processed credentialing paperwork for insurances and hospitals
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Knowledge of state and federal regulations pertaining to billing and healthcare requirements Kept a pleasant demeanor and the ability to interact with patients in a professional manner
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Filed insurance claims
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Generated and send patient bills
- Balanced daily co-pays
- Followed up with insurance companies to resolve unpaid or denied claims.
Customer Service Representative
EverCare Health Services
06.2020 - 11.2020
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
- Handled customer inquiries and suggestions courteously and professionally.
- Set up new client and vendor’s account.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Performed Customer Verification Functioned as a primary contact for over 200 patients and 300 caregivers.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Performed medical data entry of patient’s demographics, 485, oasis, referrals, medication profiles and doctors’ orders
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Obtained and evaluated all relevant information to handle product and service inquiries
- Confirmed and verified caregiver call and compilation of the hours at every pay period for billing.
Education
Queenmaris High School
Associate of Arts -
HCC
Skills
- Claims review
- Claims Processing Proficiency
- HIPAA Compliance
- Professionalism and Ethics
- Microsoft applications (Ms Office, Excel, PowerPoint, Word, and Outlook)
- Patient/Client Relations, Problem solving, HIPAA Compliance, Excellent Impersonal skills
- Revenue Cycle Management
- ICD 10, EPIC, Cerner
- Customer follow-up
- Goal-oriented mindset
Timeline
Insurance Representative II
PFS Group
06.2024 - 09.2024
Revenue Cycle Specialist
Athenahealth
01.2024 - 05.2024
Revenue Cycle Specialist
Providence Health
12.2022 - 12.2023
Medical Billing Specialist
Reddington Hospital
01.2021 - 12.2021
Customer Service Representative
EverCare Health Services
06.2020 - 11.2020
Queenmaris High School
Associate of Arts -
HCC
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