Brandi Johnson
Louisville,KY
Summary
Detail-oriented and systematic Analyst well-versed in reviewing and correcting large amounts of information and files. Quality-focused and insightful with more than 7 years of related experience. Enthusiastic and eager to contribute to team success through hard work, attention to detail, and excellent organizational skills. Motivated to learn, grow and excel. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
10
10
years of professional experience
Work History
Account Revenue Analyst
Baptist Health Hospital
08.2022 - 03.2023
- Examined medical treatment records and medical bills to gauge overall extent of liability.
- Reviewed provisions of certificates or policies to determine patient's medical coverage losses.
- Contacted clients to collect information and communicate disposition of case, documenting interactions regarding eligibility, verification of benefits and claims payment status.
- Scanned hard copy medical records and correspondence to convert into electronic files.
- Identified root cause of denials to provide plans for denial resolution.
- Adjusted client accounts by entering discretionary billing items, requesting rebills and updating billing entity records.
- Maintained contact with claimants and attorneys to determine treatment status.
- Maintained claims data in Epic systems.
- Determined proper codes for medical and patient records.
- Acquired information to analyze and investigate to provide concise explanation of why or how claim was denied/adjudicated.
Payment Integrity Analyst
The Rawlings Group
03.2019 - 08.2022
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Investigated and identified claims that were paid incorrectly by insurance plan.
- Initiated recovery of overpaid claims.
- Assisted with training of new auditors.
- Outreach to insurance plans to obtain information regarding member eligibility, claims disputes, and coordination of benefits.
- Researched employer Summary Plan Descriptions for coordination of benefits information
- Made outreach to providers regarding billing disputes, patient eligibility, and coordination of benefits.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
- Consistently meeting or exceeding personal invoicing quotas (50k month).
Billing & Enrollment Representative III
Humana Inc
09.2014 - 03.2019
- Revamped audit and rebuttal process.
- Allocated CMS funds that are received for Service Funds.
- Implemented updates and changes on Process Maps.
- Reconciled customer accounts with correct payments that are received.
- Executed billing tasks and recorded information in company databases.
- Attended meetings regarding current projects and provide written and/or oral explanations, evaluations, recommendations and conclusions.
- Successfully managed and maintained Working H1X Internal B&E and Member Support Mailbox.
- Processed and reviewed Medicare applications.
- Operated through numerous systems and databases to conduct research and provide resolution.
- Made outbound calls to members to complete application process.
- Utilized following systems: 834, 820, AE, CAS, CCP2, CGX, CI, Ebilling, Ecare, Emdeon Office, EMME, FFM, GCP, MACESS, MARX, MTV, OHPB, Paris, PBS, Preaudit, SOAP.
Police Dispatcher
Indiana University
11.2012 - 09.2015
- Maintain office files and other records for department.
- Composed reports.
- Kept detailed track of all available field personnel and all in-progress and completed calls.
- Used specialized software to track and maintain case incident numbers and logs.
- Received public emergency and non-emergency calls and supervised response prioritization in order to effectively dispatch official units such as police, tow trucks, and fire, while tracking data in real-time environments.
Education
Psychology
Indiana University Southeast
New Albany, INHigh School Diploma -
Butler Traditional High School
Louisville, KY06.2009
Skills
- Excellent customer service, problem-solving, conflict resolution, leadership skills
- Familiarity with Medical Terminology/Codes
- Identifying Overpayments
- Flexible & Adaptable
- Analytical Thinking
- Account Reconciliation
- Health Care System/ Insurance Plan Knowledge
- Data Research and Validation
- Benefits Interpretation
- Accurate Recordkeeping
- Enrollment Procedures/Coordination
- Insurance Eligibility
- Data Entry Skills
- Active Listening
- Billing Support/Procedures
- Provider Relations / Invoicing
Timeline
Account Revenue Analyst
Baptist Health Hospital
08.2022 - 03.2023
Payment Integrity Analyst
The Rawlings Group
03.2019 - 08.2022
Billing & Enrollment Representative III
Humana Inc
09.2014 - 03.2019
Police Dispatcher
Indiana University
11.2012 - 09.2015
Psychology
Indiana University Southeast
High School Diploma -
Butler Traditional High School