COURTNEY JOHNSON
Bronx
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
13
13
years of professional experience
Work History
Operations Analyst
Claritev/ Multiplan Inc
New York
11.2023 - Current
- Review, investigate, and analyze claim appeals, working closely with coders to coordinate review of documentation. Assist customer service, providers, and clients on resolution of issues or inquires.
- Research and manage claim inventory for inpatient, outpatient, and provider billing using review guidance supplied by our clinical teams.
- Request and process documentation associated with special projects and clinical review inquiries
- Access, research, and retrieve information and documentation from MultiPlan and one of various external client systems
- Data Entry and database maintenance including review, validation, and maintenance of provider data.
- Perform system claim adjustments based on appeal outcomes or to process corrected claims.
- Manage manual distribution of workflow when system is unable to assign.
- Assist with special projects as assigned in conjunction with daily workload; prioritizing and shifting focus as needed
- Collaborate, coordinate, and communicate across disciplines and departments Ensure compliance with HIPAA regulations and requirement
- Demonstrate Company's Core
Receptionist
Claritev/ Multiplan Inc
New York
07.2016 - 11.2023
- Answered and quickly redirected up to 50 calls per day.
- Maintained a clean reception area, including lounge and associated areas.
- Daily Office Operations.
- Greeting Visitors.
- Incoming Mail.
- Data Entry.
- Helped with research projects in the Credentialing/Operations department.
- Researched NPI's and implementing them onto Excel Spreadsheet.
- Worked on search engines such as MP3 Practitioner and Echo.
Eligibility Analyst
Claritev/ Multiplan Inc
New York
03.2022 - 11.2023
- Makes a high volume of outbound telephone calls, imaging documents, and completing data entry.
- Uses tools to research telephone numbers and addresses.
- Applies Coordination of Benefit (COB) Rules and establishing Order of Benefits.
- Opens and works files in home application.
- Creates and updates tracking reports.
- Gathers claim overpayment information from healthcare providers.
- Searches insurance claim database queries.
- Pursues overpayments and initiate the refund of identified overpayments.
- Collaborate, coordinate, and communicate across disciplines and departments.
- Ensure compliance with HIPAA regulations and requirements.
- Demonstrate Company's Core Competencies and values held within.
Office Manager/ Receptionist
Quality Services for the Autism Community
Bronx
04.2013 - 07.2016
- Answered and quickly redirected up to 50 calls per day.
- Ordered and distributed office supplies while adhering to a fixed office budget.
- Managed office supplies, vendors, organization and upkeep.
- Answered and managed incoming and outgoing calls while recording accurate messages.
- Opened and properly distributed incoming mail.
- Greeted numerous visitors, including VIPs, vendors and interview candidates.
- Helped distribute employee notices and mail around the office.
- Maintained a clean reception area, including lounge and associated areas.
- Drafted biweekly time sheets for 50 executives and employees.
- Completed data entry, tracked resumes and maintained the applicant tracking system.
- Screened all visitors and directed them to the correct employee or office.
- Opened and properly distributed incoming mail.
Education
Sociology -
CUNY Lehman College
BronxAssosiates in Applied Sciences - Human Services
CUNY Bronx Community College
BronxHigh School Diploma -
Central Park East High School
ManhattanSkills
- Data Entry
- Greeting
- 40 WPM typing speed
- Telephone Etiquette
- Knowledgeable in Microsoft Suites
- Eligibility Determination
- Excellent communication skills
- Professional phone etiquette
- Microsoft Office Proficiency
- Microsoft Office
- Customer service-oriented
- Articulate and well-spoken
- Pleasant demeanor
- Flexible
- Multi-line phone proficiency
- Team building
- Filing and data archiving
- Dedicated Team Player
- Strong Problem Solver
- Daily Office Operations
- Time Management
- Strong Interpersonal Skills
Timeline
Operations Analyst
Claritev/ Multiplan Inc
11.2023 - Current
Eligibility Analyst
Claritev/ Multiplan Inc
03.2022 - 11.2023
Receptionist
Claritev/ Multiplan Inc
07.2016 - 11.2023
Office Manager/ Receptionist
Quality Services for the Autism Community
04.2013 - 07.2016
Sociology -
CUNY Lehman College
Assosiates in Applied Sciences - Human Services
CUNY Bronx Community College
High School Diploma -
Central Park East High School