ADENEKAN SODIQ ADETOLA
Operation Officer
Lagos,Lagos LA
Summary
Reliable employee seeking Junior Customer Service Consultant position. Offering excellent communication. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Experienced Operation Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering many years of experience and willingness to take on any challenge.
Overview
7
7
years of professional experience
6
6
years of post-secondary education
3
3
Certifications
1
1
Language
Work History
Claims Officer
LEADWAY HEALTH
Lagos
08.2021 - Current
- Trained and Supervised the capturing team for better and optimum output.
- Processed claims for payment according to the agreed SLA.
- Received complaint from the Providers and solved within my experience.
- Liaised with team members for possible improvement to the service discharge.
- Followed up with customers on unresolved issues.
- Implemented improvements in manual and electronic billing procedures.
- Reported policy changes and company conditions affecting customer satisfaction.
- Addressed average of 7 customer inquiries and complaints each week.
- Processed and recorded new policies and claims.
- Verified client information by analyzing existing evidence on file.
- Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
- Handled medical claims consistent with client and corporate policies, procedures, best practices and regulations.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Maintained suspicious claims database and prepared reports for supervisors.
- Analyzed information gathered by investigation and report findings and recommendations.
- Directed and coordinated various investigations conducted by field investigation team.
- Organized, planned and documented materials for medical claims.
Claims Assessor
TOTAL HEALTH TRUST LIMITED
Lagos
08.2020 - 01.2021
- Received, recorded medical mails and correspondence.
- Captured vetted claims of Managed care and NHIS using software.
- Involved in the capturing of medical bills on Excel spreadsheet for quality assurance review.
- Received all correspondence and recorded them properly in the books of entry preceded to the distribution of mail, received and ensured correspondences are delivered immediately to the appropriate person.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Consulted police and hospital records when needed.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Examined medical claims forms and other records to determine insurance coverage.
Operations Management Intern
TOTAL HEALTH TRUST LIMITED
Lagos
08.2019 - 08.2020
- Studied with senior staff to develop deep understanding of team processes and full operational activities.
- Completed reports and paperwork on critical information impacting operations.
- Assisted with coordination of technical and business system process improvements.
- Offered technical assistance to support front-line teams with daily operations and special projects.
- Handled administrative and data entry work for staff.
- Trained and guided team members to maintain high productivity and performance metrics.
Administrative Services Officer
ULTIMA MEDICARE HOSPITAL
Lagos
02.2013 - 05.2017
- Managed an active calendar of appointments, filed expense reports and prepared confidential correspondence
- Keep and recorded proper medical details of the clients in the system
- Received, registered in-coming, out-going calls, mails and correspondence of the organization
- Organized and updated to date contacts list and databases of the clients
- Organized and proper arrange meetings
- Excellent up-to-date records of clients visits
- Keep proper billing records as Health Maintenance Organization officer
- Engaged with the Nurses to take medical records of the clients on the National health insurance scheme (NHIS) spreadsheet
- Created a recording system of in-coming and out- going mails; ensured electronic archiving of documents using software for easy retrieval when the need arises.
- Notified proper authorities and leadership in emergency situations.
- Improved office operations by automating client correspondence, record tracking and data communications.
- Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
Education
Health And Safety 1,2&3 - Health Aide
BRITISH INTERNATIONAL SAFETY ORGANIZATION
Wolverhampton, United Kingdom 11.2019 - 03.2020
Certificate in Environmental Impact Assessment - Health Aide
Department of Petroleum Resources
Lagos, Nigeria 11.2019 - 03.2020
Bachelor of Science - Chemistry
Federal University of Agriculture, Abeokuta
Ogun, Nigeria 01.2014 - 05.2019
Skills
Technical Operationsundefined
Certification
BRITISH INTERNATIONAL SAFETY ORGANIZATION UK
Timeline
Claims Officer
LEADWAY HEALTH
08.2021 - Current
Claims Assessor
TOTAL HEALTH TRUST LIMITED
08.2020 - 01.2021
Health And Safety 1,2&3 - Health Aide
BRITISH INTERNATIONAL SAFETY ORGANIZATION
11.2019 - 03.2020
Certificate in Environmental Impact Assessment - Health Aide
Department of Petroleum Resources
11.2019 - 03.2020
Operations Management Intern
TOTAL HEALTH TRUST LIMITED
08.2019 - 08.2020
Bachelor of Science - Chemistry
Federal University of Agriculture, Abeokuta
01.2014 - 05.2019
Administrative Services Officer
ULTIMA MEDICARE HOSPITAL
02.2013 - 05.2017
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