Briana Johnson
Nottoway,VA
Summary
Certified professional coder and biller with a solid foundation in medical coding, billing procedures, and healthcare compliance. Knowledgeable in ICD-10, CPT, and HCPCS coding systems, with strong organizational and analytical skills. Eager to apply training and certification to support accurate coding, streamline billing processes, and contribute to a healthcare team.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Reimbursement Manager
Crossroads Community Services Board
Farmville, VA
04.2025 - Current
- Oversaw reimbursement processes, ensuring compliance with regulatory standards and organizational policies.
- Developed training materials for staff on reimbursement procedures and best practices.
- Implemented process improvements that enhanced efficiency in claims submission and processing workflows.
- Collaborated with cross-functional teams to resolve complex reimbursement issues impacting service delivery.
- Mentored junior team members to develop their skills and knowledge within the field of reimbursement management.
- Collaborated with insurance providers to clarify requirements and ensure proper submission of claims for faster processing times.
Reimbursement Specialist
Crossroads Community Services Board
Farmville, VA
04.2024 - 04.2025
- Evaluated insurance claims for accuracy, ensuring compliance with regulatory standards.
- Processed reimbursement requests efficiently, minimizing delays in payment cycles.
- Analyzed reimbursement trends to identify areas for process improvement and cost savings.
- Managed claims submissions, ensuring compliance with regulatory requirements.
- Reduced aged accounts receivable balances through diligent follow-up on outstanding claims.
- Collaborated with healthcare providers to resolve billing discrepancies and improve client satisfaction.
Claims Processor
Elevance Health
Remote
02.2023 - 04.2024
- Processed and adjudicated health and claims in a timely and accurate manner.
- Maintain organized records of all claim information and customer inquiries.
- Utilized problem-solving skills to analyze and resolve customer issues related to claims.
- Ensured compliance with all relevant regulations and standards.
- Participated in ongoing training and development programs to stay current on industry best practices.
- Collaborated with internal teams to identify process improvements and implement solutions to enhance claims processing efficiency.
Revenue Cycle Specialist
Centra Health
Lynchburg, VA
01.2022 - 02.2023
- Worked with the computerized practice management system for the validation, submission, and processing of insurance and self-pay.
- Collected and entered claim information, validation, and correction of rejected claims, and claim submission to third-party payers for reimbursement.
- Manages claim denials related to referral, authorizations, notifications, non-coverage, medical necessity, and others as assigned.
- Identified trends and opportunities for process improvement to minimize claim denials and maximize reimbursement for the organization.
Medical Office Associate II
Centra Health
10.2018 - 01.2022
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
- Coordinated patient scheduling, check in and check out.
- Rescheduled, and handled cancelled appointments using desktop calendar software.
- Reviewed and sent medical records to other physicians upon request.
- Received, recorded, and filed medical payments by check, cash, and credit card.
- Gathered forms, copied insurance cards, and collected patient information for billing and insurance filing.
- Work with patients, insurance companies, and providers to obtain proper authorizations.
Education
Associate's degree - Medical Office
Southside Virginia Community College
Southside, Virginia, US12.2018
Certification
- Certified Professional Coder-A
- Certified Professional Biller
Timeline
Reimbursement Manager
Crossroads Community Services Board
04.2025 - Current
Reimbursement Specialist
Crossroads Community Services Board
04.2024 - 04.2025
Claims Processor
Elevance Health
02.2023 - 04.2024
Revenue Cycle Specialist
Centra Health
01.2022 - 02.2023
Medical Office Associate II
Centra Health
10.2018 - 01.2022
Associate's degree - Medical Office
Southside Virginia Community College