Cassandra M Johnson

Facilitated service delivery across three regions for Christus Health Systems.

• Analyzed patient account discrepancies, resolving billing issues efficiently.
• Conducted audits on insurance claims to ensure reimbursement accuracy.
• Ensured compliance with laws, regulations, and policies governing billing activities.
• Assisted in developing processes to enhance billing operations and efficiency.
• Communicated with customers, vendors, and stakeholders regarding billing inquiries.
• Performed claim analysis for all managed Medicare and Medicaid payers.
• Generated reports to guarantee proper claim processing and appropriate reimbursement.

• Reviewed claim edits in SSI and forwarded bills to payers for processing.
• Submitted claims to insurance companies, ensuring compliance with submission guidelines.
• Verified claims coding accuracy according to ICD-10 standards.
• Trained peers on claims navigation and entry within Arkansas Medicaid provider portal.
• Participated in Christus Health partnership mentoring program for professional growth.
• Executed account updates and documented information in company data systems.
• Assessed billing statements for diagnostic code accuracy, identifying coding discrepancies.
• Maintained high accuracy in daily production of completed reviews.

• Analyzed ARSU reports and requests to identify trends affecting account resolution, communicating findings to leadership.
• Collected outstanding balances from government Medicaid, commercial insurance, and patients.
• Managed all aspects of account follow-up and collections, including appeal processing.
• Maintained up-to-date knowledge of commercial and managed care pricing models, rules, and regulations.
• Reviewed explanations of benefits (EOBs) to ensure accurate claim reimbursements, reporting discrepancies.
• Applied knowledge of commercial, Medicaid, HMO/PPO procedures, contracts, and medical terminology.
• Sent clinical requests and missing information letters to secure necessary data.
• Documented file notes clearly in Connance system while providing accurate services based on healthcare regulations.

• Collected outstanding patient balances from Medicaid and commercial insurance sources.
• Managed account follow-up and collections processes, including appeals handling.
• Monitored commercial and managed care pricing models and regulatory compliance.
• Utilized expertise in insurance operations, contracts, and medical terminology daily.
• Analyzed pending claims to resolve issues hindering auto-adjudication.
• Reviewed EOBs and payer portals to verify claim reimbursements and identify trends.

• Resolved unpaid claims by following up with Medicare, Medicaid, and Commercial plans for all HCA hospitals.
• Reviewed EOBs and verified payment or denial of claims through online payer websites.
• Collaborated with carriers to address discrepancies in insurance payments.
• Secured payment on outstanding account balances through direct communication with patients and guarantors.
• Referred inquiries to appropriate parties based on customer needs.
• Ensured compliance with HIPAA Privacy and Security Regulations while managing patient information.