Channa Johnson RN
RN
Murfreesboro,TN
Summary
Detail-oriented Examiner with 20+ years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and appeals. Resourceful Healthcare professional promoting 10 years of expertise assessing coverage and overseeing claims review. Leverages well-developed communication skills to deliver information to policyholders. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
24
24
years of professional experience
Work History
Senior Claims Analyst/Nurse Preceptor/Denial Specialist
Cigna Healthcare
01.2017 - Current
- Maintained strict confidentiality with all personal data as per company guidelines.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Examined claims forms and other records to determine insurance coverage.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Charge Nurse
Southern Hills Rehab
09.2015 - 12.2016
- Coordinated nursing care on unit through staff assignments, assisting and rounding with physicians, monitoring patient orders, and communicating with ancillary departments.
- Conducted daily shift briefs to inform staff of changes in patient care assignments.
- Supervised and managed daily scheduling, tasking, and administration.
- Monitored nursing care, patient assessment processes, and treatment implementations.
- Collaborated with other healthcare professionals to provide quality patient care.
Home Health Registered Nurse
Suncrest Home Health
05.2014 - 08.2015
- Informed physicians of any changes to patients' health or concerns observed during home visits.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Provided physical assessments, medication, and chronic disease management to home health patients.
- Traveled to patients' homes on daily basis to assess health conditions and provide superior level of nursing care.
- Contacted family immediately when issues arose with at-home patients in effort to find effective resolutions.
- Trained, guided, supported and supervised home health aide care providers.
- Assessed patients' health conditions and asked appropriate questions to better understand current feelings.
- Educated patients on use and benefits of equipment such as home blood pressure cuffs and glucose meters.
Director of Operations
Amedysis Home Health Care
06.2013 - 05.2014
- Oversaw day-to-day production activities in accordance with business objectives.
- Oversaw successful implementation of operational strategies and policies to drive organizational growth and productivity.
- Collaborated with senior management to develop and execute long-term corporate goals and object
- Fostered improvement in staff development, personnel training, and standards of patient care.
- Evaluated nursing staff's performance and developed education programs and professional development opportunities to improve individual and team competencies, clinical knowledge and delivery of care.
- Interacted effectively with department managers to promptly correct problems and improve services.
- Collaborated with physicians and interdisciplinary teams to devise and manage individualized plans of care.
- Oversaw training, staffing and education of all nurses and home healthcare staff.
- Supervised professional and paraprofessional nursing staff and delegated tasks to maintain continuum of care.
Registered Nurse, Emergency Department
Stonecrest Medical Center
07.2003 - 05.2013
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Provided direct patient care, stabilized patients, and determined next course of action.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Updated patient charts with data such as medications to keep records current and support accurate treatments.
Oncology Infusion Registered Nurse
Williamson Memorial Hospital
05.1999 - 06.2003
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Monitored patient reactions after administering medications and IV therapies.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Educated family members and caregivers on patient care instructions.
- Recorded details regarding therapies to keep patient charts updated.
Education
Associate of Applied Science - Nursing Science
Columbia State Community College
Columbia, TNNursing
Baptist Memorial College of Health Sciences
Memphis, TNCertificate - Healthcare/ Wound Care
Tennessee State University
Nashville, TN1981
Skills
- Service Quality
- Liability Determinations
- Active Listening
- Fraud Patterns
- Document Organization
- Information Updates
- Field Auditing
- Outpatient Procedures
- Reimbursement Management
- Operational Standards
Timeline
Senior Claims Analyst/Nurse Preceptor/Denial Specialist
Cigna Healthcare
01.2017 - Current
Charge Nurse
Southern Hills Rehab
09.2015 - 12.2016
Home Health Registered Nurse
Suncrest Home Health
05.2014 - 08.2015
Director of Operations
Amedysis Home Health Care
06.2013 - 05.2014
Registered Nurse, Emergency Department
Stonecrest Medical Center
07.2003 - 05.2013
Oncology Infusion Registered Nurse
Williamson Memorial Hospital
05.1999 - 06.2003
Associate of Applied Science - Nursing Science
Columbia State Community College
Nursing
Baptist Memorial College of Health Sciences
Certificate - Healthcare/ Wound Care
Tennessee State University
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