Adam G. Johnston
Belmont
Summary
Medicare subject matter expert with a proven track record in sales and billing, delivering high productivity and efficient task completion. Specialized in policy customization and client needs analysis, ensuring tailored solutions for diverse client requirements. Strong communication and problem-solving skills foster trust and long-term relationships, particularly in Medicare products.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Premium Managment Supervisor - Senior Markets
Priority Health
Grand Rapids
09.2014 - Current
- Managed daily operations of billing department to streamline processes and workflows for Medicare Advantage and Medigap products.
- Supervised billing team to ensure accurate invoicing and compliance with policies.
- Trained staff on billing software and procedures for improved efficiency.
- Coordinated communication between billing and other departments to resolve discrepancies.
- Implemented process improvements to enhance billing accuracy and reduce errors.
- Scheduled regular meetings with team to discuss challenges and share updates.
- Prepared detailed reports on current status of all outstanding bills.
- Resolved customer complaints related to billing issues.
- Ensured accuracy and completeness of billing data in the system.
- Created daily, weekly, monthly metrics tracking documents for management review.
- Supervised a team of 6 Billing Department staff members.
- Reconcile and process CMS payments on behalf of beneficiaries based on risk scores and premiums.
Medicare Sales
Priority Health
Grand Rapids
07.2011 - 08.2014
- Educated clients on Medicare options and benefits to ensure informed decisions.
- Conducted presentations to community groups about Medicare plans and services.
- Assisted clients with enrollment processes using online and paper applications.
- Collaborated with healthcare providers to resolve client inquiries efficiently.
- Developed marketing materials to promote Medicare products in local communities.
- Attended industry conferences to stay updated on Medicare policies and trends.
- Presented and clearly explained insurance policy options based on clients' needs and goals.
- Assisted customers with selecting appropriate plans based on their needs.
- Attended trade shows, conferences, and other networking events related to healthcare benefits.
- Advised customers on various aspects of their health insurance policies.
Client Service Representative
CU*Answers
Grand Rapids
04.2009 - 07.2011
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Completed day-to-day duties accurately and efficiently.
- Provided software support and general technical solutions for operational, database and security requirements in applications.
- Contributed ideas for improving current operational processes related to software support activities.
- Identified opportunities for automation of processes related to software support activities.
- Provided support for existing software applications.
Education
Communications
Grand Rapids Community College 2001-2002
Grand Rapids, MISkills
- Billing software
- Invoice processing
- Customer relationship management
- Metrics tracking
- Regulatory knowledge
- Process improvement
- Team supervision
- Healthcare coordination
- Effective communication
- Processes and procedures
- Time management
- Documentation and reporting
- Staff training
- Relationship building
- Public speaking
- Goal oriented
- Operational efficiency
- Data analysis
Certification
State of Michigan Producer Insurance License
Health and Accident - Active/Compliant
System ID: 0680164
NPN: 17256829
MARx - Medicare Advantage Prescription Drug System
- Proficiant user as it allows to view member eligibility such as Part A, B, D entitlements, Late Enrollment Penalty and a 360 view of the member in the scope of the government.
Timeline
Premium Managment Supervisor - Senior Markets
Priority Health
09.2014 - Current
Medicare Sales
Priority Health
07.2011 - 08.2014
Client Service Representative
CU*Answers
04.2009 - 07.2011
Communications
Grand Rapids Community College 2001-2002
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