Mojeedat Abdussalaam

Scsr Claims Analyst @Blue Cross Blue Shield Association

Dallas-Fort Worth, TX, US

Engaged to input data into processing system after interpreting medical coding and knowing terminology used in medicine professions in respect to procedures and diagnoses. Creates management reporting tools to enhance communication on configurations updates and initiatives. Ensured to process assigned claim forms and inspect apt allocation of co-pays, deductibles, reimbursements and co-insurance. Review contracts between hospitals and insurance carriers, model claims data, and identify lost revenue. Contact responsible party for claim payment. Prepare and forward claim appeal letters with supporting documentation for denial overturn. Communicate with teammates and leadership to discuss and identify trends. Perform analysis on large data sets to identify underpayment and denial trends. Conduct research on current laws and regulations pertaining to hospital reimbursement methodology. Creates claim adjustments, retro adjudications due to rate changes, and reprocessing projects identified during the internal audit process. Assists with projects and internal or external audits. Create and keep current internal Standard Operating Procedures and reference tools, providing related training to team members. Responsible for identifying efficiencies and recommending process improvements to increase auto-adjudication rates and reduce manual processes.

University of Abuja

Bachelor's degree, Microbiology, General

MATE University

Diploma, Research Microbiology

Georgia Institute of Technology

Master's degree, Data Analytics