SHAKIRAT OMOIKE
Little Elm,TX
Summary
Detail-oriented Revenue Cycle Specialist with a systematic nature and good grasp of billing processes. Successful planner and problem-solver. Ready to apply 5 years' experience in revenue cycle management for medical facilities such as hospitals and insurance sector. Proficient in reducing debt, collecting payments and collaborating with insurance companies to resolve concerns. Talented communicator and practiced multitasker.
Overview
7
7
years of professional experience
Work History
Project Coordinator/Revenue Cycle Specialist
BC Services
Colorado City, CO
02.2022 - 01.2024
- Daily communication with insurance/payers either commercial or government to resolve discrepancies towards reimbursement on claims
- Utilized workflow systems such as STAR and EPIC to collect payments and resolve accounts.
- Demonstrated working knowledge of the insurance follow-up process, ensuring timely reimbursement.
- Applied understanding of government, Medicare, and Medicaid claims to effectively handle reimbursement processes.
- Conducted thorough follow-up with payers through various communication channels to resolve outstanding claims.
- Accurately reviewed and updated patient and financial information, ensuring data integrity.
- Verified the accuracy of information regarding responsible parties for bill payment, including individuals and insurance companies.
- Examined and worked on claims needing medical record request from payers
- Track common claim errors, identify and report inaccurate reimbursement and contractual trends
- perform follow up actions and documents follow up activities, conversations with payers.
- Daily communication with insurance companies and other commercial insurers to address coordination of benefits and claim resolution
- Contact patients if claim is missing correct information or member id is incorrect for claim to process
- Work within payer portals and interact with third-party payors and patients to resolve account balances
- Sets follow up activities based on the status of claim
- identified billing errors, underpayment or overpayment and resolved them accordingly
- Notating accurate information on the status on claims stated by payer and finding possible resolution for proper reimbursement
- Review, analyze, resolve, and trend for complex claims issues and payer behavior using Client billing system, payor portals, calling the payer, and EOB review
- Review daily clearinghouse rejections, resolving, and resubmitting accounts
- Post adjustments and collection of medicare, medicaid, and commercial insurance payers
- Observed legal and ethical guidelines of HIPAA for safeguarding patient and company confidential and proprietary information
- Review aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when needed
- Submit corrected claims billing
Revenue Cycle Specialist
Northside Hospital Atlanta
Atlanta, GA
03.2020 - 01.2022
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Proactively monitored and corrected any billing errors or discrepancies, ensuring accuracy and compliance.
- Assured timely billing of hospital services to primary insurers or patients within expected timeframes.
- Implemented effective follow-up procedures with insurance companies, ensuring timely resolution of assigned accounts.
- Provided clear explanations of hospital regulations and insurance policies to patients, promoting understanding of payment processes.
- Ability to multitasks including navigating between computer applications while speaking with participants/patient
- Processed hospital claims and insurance collections commercial entity as well as government entity
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Posted payments and collections on regular basis.
- Provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
- Recognize operational challenges and suggest recommendations to management, as necessary
Revenue Cycle Specialist
Medix Staffing
Irving, TX
06.2019 - 02.2020
- Recognize and find resolution to potential issues within claims
- Work and managed claims from all aging buckets including posting and appeals
- Contacting/sending letter to patients for patient pending balance which is patient responsibilities applied to either copay, co insurance or deductible
- Demonstrated professionalism, cooperation, and courtesy in interactions with patients, insurance payors, colleagues, and management.
- Successfully completed special projects and additional duties as assigned by the management team, showcasing flexibility and adaptability
- Sending appeals to appropriate payers depending on denial reason for reimbursement of claims
- Ensuring claims are billed at appropriate time to avoid going past timely filing
- Contacting payer for status updates on claims and probing live agent for accurate claim information
- Research missing payments and secure documents needed for posting
- Contact patient for COB update when necessary.
- Contacted responsible parties for past due debts.
- Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
- Outbound calls to insurance companies to verify coverage,eligibility as well as claim status
- Reviewed EOBs for correct payment, deductible, adjustments and denials
- Investigates and coordinates insurance benefits for claims across multiple service lines
Customer Service Representative
Wipro
Dallas, TX
02.2017 - 05.2019
- Handled customer inquiries and suggestions courteously and professionally.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly services
- Accurately capture conversations with customers and notate correctly
- Resolve customers issues in regards to their benefits and eligibility
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Managing customers medicaid accounts
Education
Bachelor of Science - Business Administration
University of Lagos
Nigeria04-2010
Skills
- Medical Billing
- Claims Review
- Coordinating Documents
- Detail oriented
- Hospital billing/UB04/CMS1500
- Maintaining detailed records
- Customer service
- Healthcare billing proficiency
- Proficient with Microsoft 365 tools
Timeline
Project Coordinator/Revenue Cycle Specialist
BC Services
02.2022 - 01.2024
Revenue Cycle Specialist
Northside Hospital Atlanta
03.2020 - 01.2022
Revenue Cycle Specialist
Medix Staffing
06.2019 - 02.2020
Customer Service Representative
Wipro
02.2017 - 05.2019
Bachelor of Science - Business Administration
University of Lagos
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