Opaluence Foster
Arlington
Summary
Detail-oriented Medical Collector (RCM Specialist) with extensive knowledge of billing and collection procedures and a decade of experience in the medical field. Proven time management and problem-solving skills enhance the ability to navigate complex challenges effectively. Strong researcher adept at identifying discrepancies and optimizing collection processes, ready to leverage expertise in a dynamic environment that fosters professional growth. Committed to delivering exceptional results while maintaining the highest standards of accuracy and compliance.
Overview
8
8
years of professional experience
Work History
Credit Analyst
Ernest Healthcare
Remote
10.2024 - Current
- Analyzed credit data and financial statements to assess risk profiles and creditworthiness.
- Conducted thorough reviews of contracts to determine that payor paid according to contract terms and guidelines.
- Led initiatives to refine PPR assessment criteria, reducing default rates system calculations.
- Collaborated with other teams to identify and mitigate payor risks impacting organization.
Medical Insurance Follow up Specialist
Omega Healthcare
Remote
06.2023 - 01.2025
- Followed up with insurance companies to verify claim status and facilitate timely payments.
- Reviewed and updated patient accounts to ensure accurate billing information.
- Processed an average of 40 accounts with 97% daily accuracy.
- Collaborated with department teams to update weekly trends, increase in volume based on payor and address discrepancies in claims processing.
Medical Denials Specialist
Currance
Remote
11.2021 - 03.2023
- Managed medical billing records for accuracy and compliance with insurance requirements.
- Addressed insurance denials through detailed investigation and resubmission of claims using payor portals, automatic phone lines and chat portals to resolve denials.
- Completed a daily average of 35 claims in Epic EHR by working within assigned payors and delinquency.
- Handled appeals for denied claims through strategic communication and documentation.
Revenue Cycle Specialist
Prime Healthcare
Plano, TX
02.2018 - 07.2020
- Posted payments from insurance companies and patients to the appropriate accounts.
- Handled denial management by investigating reasons for claim rejections and resubmitting when necessary.
- Submitted insurance claims in accordance with policies and procedures to maximize reimbursement.
- Maintained 95% accuracy in resolving claim denials and payments posted for assigned regions.
Education
Bachelor of Applied Science - BASc, Healthcare Administration
University of North Texas
01.2016
Skills
- HIPAA compliance expertise
- Collections expertise
- Proficient in EMR systems
- Effective time management
- Proficient in Microsoft Office Suite
- Risk analysis
- Risk analysis in credit
Timeline
Credit Analyst
Ernest Healthcare
10.2024 - Current
Medical Insurance Follow up Specialist
Omega Healthcare
06.2023 - 01.2025
Medical Denials Specialist
Currance
11.2021 - 03.2023
Revenue Cycle Specialist
Prime Healthcare
02.2018 - 07.2020
Bachelor of Applied Science - BASc, Healthcare Administration
University of North Texas