Devonna Johnson
Citrus Heights,CA
Summary
Experienced Medical Biller and Accounts Receivable professional with an excellent track record of swiftly identifying and rectifying claims, ensuring seamless submissions and prompt payments. Multitasking, time management, and Microsoft Office and Excel proficiency set my abilities apart. Extensive experience in hospital, physician, and mental health billing provides a deep understanding of billing guidelines and regulations. Strong attention to detail, organizational skills, and analytical mindset make navigating complex tasks seamless, ideal for a fast-paced healthcare environment. Also, strong interpersonal and team-building skills enhance the ability to thrive in any dynamic and fast-growing healthcare setting.
Overview
12
12
years of professional experience
Work History
Claims Analyst
A-Line Staffing
01.2023 - Current
- Conducts in-depth analysis of mental health, substance abuse, and autism claims, showcasing a thorough understanding of complex medical cases
- Identifies trends related to diagnosis, eligibility, authorizations, member demographics, and coding issues, demonstrating a keen eye for detail and a commitment to ensuring accuracy in claims processing
- Reviews and resolves system edits using multiple systems, processes, and procedures, indicating proficiency in navigating complex healthcare systems
- Demonstrates the ability to address 100 claim processing issues promptly and efficiently each day, contributing to streamlined workflows and minimizing delays in reimbursement.
- Streamlined workflow processes for improved efficiency and reduced claim resolution times.
Appeals and Grievance Coordinator
Randstad
01.2021 - 01.2022
- Improved member satisfaction by efficiently managing and resolving appeals and grievance cases.
- Streamlined case management by implementing a well-organized tracking system for all incoming appeals and grievances.
- Demonstrated high-level attention to detail when reviewing medical records, provider contracts, and other relevant documents during case assessments.
- Enhanced internal processes for handling complaints by developing standardized guidelines and documentation templates.
- Collaborated with interdisciplinary teams to review cases, identify trends, and develop strategies for addressing recurring issues.
Biller
Modis
01.2020 - 01.2021
- Assessed spreadsheets containing credit balances, showcasing the ability to make informed decisions on refunds or account adjustments
- Conducted thorough research on member information to ensure accurate billing outcomes, emphasizing attention to detail and commitment to precision in financial transactions
- Utilized a systematic approach to verify and validate member data, contributing to the overall integrity of billing processes
- Upon full payment, retroactively reinstated member coverage from the termination date, demonstrating a commitment to fair and timely resolution of payment-related issues
- Highlighted the ability to navigate administrative processes to reinstate coverage efficiently, contributing to member satisfaction and retention.
- Verified the accuracy of accounts payable payments, resulting in a 99.1% reduction in payment errors and check reissues.
Owner/Operator
Triple Platinum Auto Sales
01.2018 - 01.2021
- Showcased strategic vision and decision-making to achieve financial success through effective inventory management, marketing strategies, and a commitment to exceptional customer service
- Managed staff effectively, showcasing leadership skills in creating a productive and positive work environment.
- Managed daily operations for optimal efficiency, streamlining processes to reduce costs.
- Provided exceptional customer service, addressing issues promptly to ensure customer satisfaction and repeat business.
- Oversaw the hiring process, selecting highly skilled candidates who contributed significantly to the company's success.
Workers Compensation Biller
Optum360
01.2017 - 01.2018
- Oversee workers' compensation billing and collections, demonstrating a commitment to strict adherence to state regulations and guidelines.
- Pay close attention to Department of Insurance (DOI) regulations and authorizations on file for the patient, ensuring a thorough and compliant claims processing approach.
- Demonstrate attention to detail and expertise in reviewing complex medical documentation, contributing to the accuracy and completeness of claims submissions.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Verified the accuracy of accounts payable payments, resulting in a 100% reduction in payment errors and check reissues.
Appeals and Grievance Coordinator
Kelly Services Inc.
01.2017 - 01.2017
- Resolved complex cases by applying a combination of investigative skills, regulatory knowledge, and collaboration, ensuring satisfactory outcomes for constituents
- Maintained detailed case files and databases, showcasing organizational skills and attention to detail in tracking progress and documenting key details.
- Ensured adherence to congressional guidelines by systematically recording and updating case information, contributing to efficient and compliant case management
- Expedited resolution times by proactively communicating with members, providers, and other stakeholders throughout the grievance process.
- Ensured timely submission of required reports to regulatory agencies by diligently monitoring deadlines and maintaining accurate records.
Senior Collections Representative
Kforce
01.2015 - 01.2016
- Developed and implemented strategies to enhance collections and reduce delinquency rates by identifying and resolving trends, showcasing analytical skills and the ability to address root causes of billing issues
- Addressed complex billing cases through effective communication and negotiation, contributing to positive outcomes and resolution of financial disputes
- Attention to detail reduced delinquency rates with proactive strategies and timely follow-ups on overdue accounts.
- Identified trends in delinquent accounts to anticipate potential issues and proactively address them before they escalated into more significant problems.
Biller/Registration
Stanford Healthcare
01.2012 - 01.2015
- Verified insurance coverage, obtained necessary authorizations, and accurately documented patient information, showcasing attention to detail and efficiency
- Collected the patient's share of cost or outstanding balances during service, demonstrating a commitment to transparent and efficient financial transactions
- Demonstrated a commitment to maintaining accuracy, efficiency, and patient satisfaction throughout the registration process
- Investigated claim denials, identified root causes, and prepared thorough appeals, demonstrating problem-solving skills and a commitment to addressing issues at their source
- Leveraged strong communication skills for effective advocacy, contributing to successful appeals and resolution of billing challenges
- Proactively reviewed claims in the clearinghouse, identifying and correcting errors to facilitate prompt payment and maintain a streamlined billing process.
- Collaborated with internal and external departments to resolve billing issues, optimize revenue cycle management, and ensure optimal financial outcomes.
- Maintained accurate records by updating patient demographics, insurance, and financial information.
Education
Associate of Arts - Social And Behavioral Sciences
Merritt College
Oakland, CA05.2012
Skills
- Analytical
- Organizational
- Time Management
- Microsoft Office
- Excel
- Outlook
- PowerPoint
- Claims Analysis
- Dispute Tracking
- Data Interpretation
- Policy Interpretation
- Proficient in Epic, NextGen, Cerner, Noridian
- Interpersonal and Written Communication
Timeline
Claims Analyst
A-Line Staffing
01.2023 - Current
Appeals and Grievance Coordinator
Randstad
01.2021 - 01.2022
Biller
Modis
01.2020 - 01.2021
Owner/Operator
Triple Platinum Auto Sales
01.2018 - 01.2021
Workers Compensation Biller
Optum360
01.2017 - 01.2018
Appeals and Grievance Coordinator
Kelly Services Inc.
01.2017 - 01.2017
Senior Collections Representative
Kforce
01.2015 - 01.2016
Biller/Registration
Stanford Healthcare
01.2012 - 01.2015
Associate of Arts - Social And Behavioral Sciences
Merritt College
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