Brenda Johnson
Conyers,GA
Summary
Secure a challenging and responsible position in the healthcare sector that will allow me to utilize the skills acquired and to make a positive impact in the company through my expertise and ethics.
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Account Resolution Specialist
Elevate PFS
25700 Interstate 45 North, Suite 300 Spring, Texas
06.2025 - Current
- Resolved complex account discrepancies through thorough investigation and analysis of financial records.
- Collaborated with cross-functional teams to enhance customer satisfaction and streamline resolution processes.
- Provided expert guidance on account management strategies, improving overall team performance and efficiency.
- Mentored junior staff on best practices for dispute resolution and account reconciliation techniques.
- Analyzed trends in account issues to identify root causes and recommend strategic solutions to management.
Revenue Recovery Specialist
Knowtion Health
Raton, Florida
03.2023 - 04.2025
- Manage an inventory from multiple clients with a variety of accounts with complex denials, such as…
- New and priority accounts to be worked within 48 business hours
- Aged and high dollar accounts to be worked as necessary to ensure efficient revenue cycle recovery
- Accounts that require substantive review by the coding and utilization departments
- Identify and resolve denials to obtain timely payment for clients
- Prepare and submit appeals with required documentation in a timely manner
- Use professional notation that is clear, concise and comprehensive throughout the complex claim resolution process
- Maintain professional relationships and communication with patients and payer representatives
- Learn and implement client specific protocols and procedures
- Demonstrate proficiency with web portals, client systems, and databases as necessary to document and resolve accounts
- Identify recent payer resolution trends and relay them to peers
- Communicate questions and concerns proactively to supervisor for resolution
- Responsible for full revenue cycle billing for medical claims to ensure proper reimbursement for services rendered
- Resolve issues with pending, rejected or denied insurance claims, through re-submissions and appeals driving in net collections
- Ensuring that all payment postings from various payers happen in an accurate and timely manner
- Communicating with patients regarding outstanding balances, questions about their bills, and setting up payment plans when necessary
- Responsible for managing insurance A/R follow ups and resolution of all insurance claim billing errors
- Act as a liaison, when necessary, between internal and external partners to resolve claims and billing issues
- Identify trends or issues and initiate corrective action to improve revenue cycle management claim resolution rates
- Provide feedback and advice on product/technology/service improvements
- Own ad hoc operational efficiency projects as needed by the Director of Health Plan Operations
Denial and Appeals Specialist
Bay Area Hospital
Coos Bay, OR
07.2022 - 01.2023
- Resolved payment status and denials for claims through effective communication with insurance carriers.
- Entered critical patient and treatment information to support accurate insurance claim submissions.
- Ensured completeness and accuracy of all submitted claims to minimize rejections.
- Systematically reviewed payment denials and addressed issues promptly.
- Managed each account from initiation to resolution, maintaining thorough documentation.
- Processed write-offs and adjustments according to payor contracts for non-payable charges.
- Executed follow-ups on outstanding accounts receivable using ATB worklist reports.
- Monitored and followed up on at least 45 outstanding claims daily, enhancing collection efficiency.
Revenue Cycle Specialist
Banner Health
Greeley, CO
06.2021 - 07.2022
- Specialized in resolution of patient accounts (commercial and government) Specialty Billing in EPIC (facility and physician claims)
- Specialized in Commercial / Medicare Advantage (HMO.PPO, EPO, IPAs etc ) and government insurance inquiries and billing
- Self-pay accounts, specialty Denial Management Collector on current and delinquent accounts
- A/R follow up, appeal reconsiderations preparations and submission
- Contact various government agencies to resolve any billing queries and follow up on outstanding account balances due
- Contacted the insurance companies to confirm coverage, deductible, co-payment requirement and any other details needed
Senior Account Representative
ABLM Inc
Austin, TX
10.2016 - 06.2021
- Day to day handling of various patients accounts through extensive billing, collections and payor source follow up
- Resolved patients accounts issues through quality customer service
- Accurately and efficiently post payments and adjustments
- Communicate effectively with the entire Revenue Cycle system to determine that the appropriate records, files and timely documentations is enforced
- Worked all self-pay accounts to ensure that all patients' payment /s (inclusive of co-payments) are requested and collected; additionally, ensuring that all outstanding balances are properly accounted for and collected in a timely manner
- Arrange for payment of all insurance deductibles and co-payments due prior to admission/services
- Complete assigned Self-Pay Collections queues on a daily basis
- Estimate charges and collects deposit from all patients who are self-funding their hospital care
- Contact patients to follow up on payment due, arrange payment plans, and resolve any patient queries
- Perform any additional duties as requested by the Revenue Supervisor or PFS Manager
Reimbursement/ Underpayment Specialist
Gentiva Health Services
Atlanta, GA
01.2009 - 09.2016
- Audit insurance claims and search for underpayments
- Negotiated with insurance companies for settlement payments
- Collected insurance data for review to ensure timely resolution on Existing and outstanding issues
- Reviewed insurance claims to determine which claims requires an appeal
- Consistently follow-up with insurance companies to discover the determination And the appeal process level
- Write letters to insurance companies to resolve denials
- Process the original claims determination correspondence
- Maintain a call log inside the patient electronic file
- Resubmitted claims as required
- Crossed-trained in the billing claims process, resolved billing inquiries and Enter patient information into system
- Escalated contract issues to the Supervisor
Education
Diploma - Education
Devry Institute of Technology
Decatur, GA, USHigh School -
Decatur High School
Decatur, GA, USSkills
- EMR Systems
- Microsoft Office Suite
- EPIC (Resolute) 2015
- Werner (Soaring)
- Access Management Office
- Med Asset
- Cerner One Chart
- Emdeon
- DDE
- Epic
- Latitude
- Claims Administrator
- Excellent communication skills
- Hospital Experience
- Insurance Verification
- Accounts Receivable
- Client relationship building
- Claims processing
- Goal-oriented mindset
- Outbound calling
- Credit and collections
Accomplishments
- Documented and resolved 90 days past due claims which led to resolving high dollars claims that haven't been work in the past 90 days to bring in a revenue of $450,000 .
Certification
- Certified Medical Terminology , Emory HealthCare 3 months.
Timeline
Account Resolution Specialist
Elevate PFS
06.2025 - Current
Revenue Recovery Specialist
Knowtion Health
03.2023 - 04.2025
Denial and Appeals Specialist
Bay Area Hospital
07.2022 - 01.2023
Revenue Cycle Specialist
Banner Health
06.2021 - 07.2022
Senior Account Representative
ABLM Inc
10.2016 - 06.2021
Reimbursement/ Underpayment Specialist
Gentiva Health Services
01.2009 - 09.2016
High School -
Decatur High School
Diploma - Education
Devry Institute of Technology
Personal Information
- Willing To Relocate: Anywhere
- Authorized To Work: US for any employer