Rufus Asemota

Dallas,GA

Summary

Detail-oriented healthcare operations professional with experience supporting insurance claims, benefit verification, eligibility review, prior authorization processes, documentation, and high-volume case management. Skilled in reviewing requests against established guidelines, communicating with patients, providers, documenting decisions in electronic health record and claims systems, Strong knowledge of HIPAA, healthcare terminology, regulatory compliance, and Microsoft Office. Brings additional experience in logistics, records management, inventory accountability, and cross-functional coordination through U.S. Army Reserve service.

Overview

years of professional experience

Work History

Healthcare Operations / Claims Specialist

Experis Health

10.2024 - Current

Review and evaluate healthcare service requests, prior authorization information, and supporting documentation against established payer criteria, plan requirements, and applicable guidelines.
Verify member eligibility, benefits, coverage details, and authorization requirements using internal systems and payer portals to support accurate and timely case processing.
Review claims and authorization-related information for completeness and accuracy, identifying missing documentation, coverage issues, and potential barriers to processing.
Document authorization decisions, case activity, follow-up actions, and supporting details accurately in electronic medical record, claims, and workflow systems.
Communicate with patients, healthcare providers, and insurance payers to clarify coverage, authorization requirements, documentation needs, and claim or referral issues.
Manage a high-volume caseload while balancing accuracy, productivity, service-level expectations, and timely follow-up while maintaining HIPAA and regulatory compliance.

Unit Supply Specialist

U.S. Army Reserve

Fort Gillem, GA

08.2020 - 08.2026

Maintained accurate accountability, documentation, and records for organizational equipment, supplies, and property in accordance with established policies and procedures
Performed detailed data entry and record updates while maintaining accuracy, confidentiality, and compliance with applicable procedures.
Coordinated with internal teams and leadership to resolve discrepancies, prioritize requests, and ensure timely completion of assigned tasks.
Managed multiple priorities in a deadline-driven environment requiring attention to detail, organization, communication, and problem solving.
Prepared and maintained documentation for audits, inspections, inventory reconciliation, and accountability requirements.

Education

B.S. - Healthcare Administration & Informatics

University of North Georgia

Skills

EMR/EHR Documentation Electronic Records Management Prior Authorization Referral Coordination Eligibility & Benefits Claims Processing Case Documentation HIPAA Healthcare Privacy Documentation Standard Microsoft Office Suite (Excel, Word, Outlook), Data Entry CRM/Workflow Systems Electronic Documentation Customer Service Patient Communication Conflict Resolution, Time Management, Team Collaboration

Timeline