Jennifer Schulze Johnston
Healthcare Revenue Cycle Manager/Director
Bothell,Washington
Summary
Dedicated healthcare professional with over 25 years of experience in healthcare administration, revenue cycle, and management. Seek to maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Proven expertise in supervisory roles, project management, and training. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Proficient in various software systems.
Overview
28
28
years of professional experience
Work History
Business Office Assistant/Billing Specialist
Mission Healthcare At Bellevue
10.2023 - Current
- Bill commercial & Managed Medicare insurance
- Follow up on aging accounts and denials
- Assist patients and family members with billing questions
- Post insurance payments
Business Office Director/Manager/Lead Patient Account Rep, Medicare Biller
UHS, Inc, Fairfax Hospital
07.2019 - 09.2023
- Completed weekly A/R Minutes & reviewed with CFO/CEO, UR, & Regional Directors
- Attended meetings with Insurance Representatives for updates & issue escalation
- Ran & distributed daily/weekly reports for staff (i.e. Unbilled, Payment/Adjustment, etc)
- Trained new employees
- Managed special projects and analytics for Business Office as needed
- Assisted in maintenance of denial log to include working high-priority denial/appeals
- Billed all BHASO claims for Involuntary admissions (ITA)
- Billed all Medicare/Managed Medicare claims - Followed up on aging accounts and appeal submissions
- Served as the primary resource for Business Office (Financial Counselor, Billing, Cash Posting)
- Back-up Poster for facility revenue
- Maintained weekly/monthly reporting
- Maintained denial logs
- Managed payroll
- Conducted coaching/disciplinary actions
- Maintained employee files
- Worked with vendors
Business Office Assistant/Billing Specialist
Mission Healthcare At Bellevue
11.2017 - 07.2019
- Billed commercial & Managed Medicare insurance
- Ran and sent out private pay statements - Followed up on aging accounts
- Assisted patients and family members with billing questions
- Posted insurance payments
- Maintained facility resident files - Verified insurance eligibility
- Maintained employee files
- Handled miscellaneous HR duties (e.g., employment verification, assisted employees as needed)
- Provided back-up assistance for payroll
- Assisted in PBJ submissions to CMS
- Ran E-Verify and DSHS background checks for new/current employees as needed
Sales Associate
Fred Meyer Jewelers
11.2016 - 11.2017
Supervisor
Neighborcare Health
06.2016 - 09.2016
- Billing and Coding
- Supervised a team of 10
- Assisted in daily coding and billing
- Assigned/distributed and assisted with workload when team members were out
- Distributed daily reports of unbilled numbers
- Managed team time cards
- Managed requests for time off - Professionally & discreetly discussed issues with team members as needed, including verbal and written warnings
- Distributed employee’s weekly reports such as productivity, encounters on hold, billable/unbilled, high dollar, aging, etc
- Took escalated patient calls as needed for resolution
Risk Adjustment Specialist
Molina Healthcare of WA
03.2012 - 05.2016
- Designed, implemented, and successfully managed State Plan Medicare Risk Adjustment Program
- Currently assist in managing Medicare Risk Adjustment Program for State Health Plan
- Distributed Molina Risk Adjustment forms to providers
- Acted as the State Health Plan Liaison with Corporate Risk Adjustment Management
- Contacted and met with providers for engagement in Risk Adjustment programs
- Requested, tracked, and managed medical records received for provider incentive payments
- Monitored acceptable & unacceptable program forms received for incentive payment
- Requested medical records as needed
- Ran reports as necessary for providers and internal needs
Registry Coordinator
Swedish Medical Center
03.2010 - 03.2012
- Quality and Patient Safety
- Coordinated participation in internal and external data registries
- Abstracted clinical data from EPIC for quality projects: SCIP and SCOAP
- Entered data into applications
- Identified and tracked patients to assure complete capture of data sets
- Improved data capture methods to achieve greater accuracy and efficiency
Regulatory Specialist
Health Services NorthWest
01.2009 - 03.2010
- Submitted claims to Medicare via EPIC & Meditech
- Reviewed Medicare denials
- Met goals for A/R days and incoming payments
- Adjusted claims per guidelines
- Initiated adjustments on accounts per guidelines
- Submitted reconsideration/appeals requests to Medicare
- Reviewed claims to ensure a clean claim is submitted
- Worked claims in Return to Provider (RTP)
- Tracked CMS Probe Audit amounts & reported to Billing Director & Senior Director of Operations
- Followed up on all claims for Audit from initial medical records request to appeals
- Above average accounts worked per day
- Served as a resource for Lead in researching billing regulations
- Assisted teammates as necessary to meet departmental goals
Care Specialist, MMOP/WMIP
Molina Healthcare of Washington
03.2008 - 01.2009
- Received and loaded authorization requests received via fax or phone
- Determined if procedures requested met interqual
- Made quarterly calls to members to check health status/needs
- Assisted members in resolving billing issues as necessary
- Assisted members in finding participating providers - Notified providers of approvals/denials via phone or fax
- Assisted in finding appropriate CPT, HCPC and ICD-9 as necessary
- Worked with the Clinical Staff & Medical Director in case managing member’s care
- Served as a team resource for authorizations and interqual
Utilization Management Coordinator
Molina Healthcare Of WA
10.2007 - 03.2008
- Received and loaded authorizations received from providers into the system
- Verified CPT for authorization request
- Obtained necessary clinical notes to process authorization request
- Routed authorization requests to appropriate persons
- Notified providers of approvals/denials via phone or fax
- Adhered to the turn-around times for authorization completion
Compliance Auditor
Accountemps/Protiviti, Robert Half, Inc, Overlake Outpatient Rehab
09.2007 - 10.2007
- Reviewed pre-selected charts
- Compared documentation in charts with CPT coding billed
- Identified and documented inconsistencies in charting and coding
- Documented results of audit in a spreadsheet
- Presented findings with Department Manager and Audit Manager
- Provided suggestions for improvement in charting/coding compliance
Eligibility Counselor
Intermountain Healthcare, IHC, IHC-LDS Hospital
04.2006 - 08.2007
- Excellent at screening patients for funding
- Assisted patients in completing applications for Medicaid, Crime Victims, and other funding sources
- Followed up on application status for programs
- Worked daily reports: unbilled, aging
- Assisted walk-ins (customers without an appointment)
- Worked with Case Managers regarding medical coverage & funding for treatment
- Visited inpatient customers in rooms
- Financial Assistance pre-approvals
- Collected deposits from patients
- Authorized posting of medications to accounts per guidelines
- Referred appropriate accounts to outsource vendors (i.e., sent accounts to collections)
- Served as a team resource person
- Acted as the Acting Team Lead and Trained new hires
- Provided cost estimates for procedures based on CPT
- Worked with Supervisor to identify areas for improvement & resolution
- Created “cheat sheets” & training modules for eligibility screening
Patient Service Rep III-Medicare
IHC-Urban Central Region Billing
08.2003 - 04.2007
- Worked daily reports: credit, unbilled, payment/adjustment, aging
- Handled accounts for four Hospitals
- Worked in RTP (Medicare) correcting claim errors from the billing team
- Billed insurances, Medicare primary and all secondary insurances (UB & 1500)
- Made payment arrangements with patients
- Assisted with customer and insurance billing inquiries
- Verified insurance payments are correct
- Ensured the patient received the correct statements
- Sent accounts to collections
- Served as an excellent MSP billing resource
Health Unit Coordinator/Registrar
Primary Children's Medical Center, IHC
07.1998 - 08.2007
- Verified and entered doctor’s orders
- Received results from lab and radiology technicians
- Notified departments and nurses of orders
- Answered multiple phone lines
- Registered patients
- Served as a team resource person
- Collected deposits from patients
- Determined appropriate ER charges based on chart notes
- Assisted in educating clinical staff on charting to ensure accurate charges on account
- Entered charges in patients’ accounts
- Assisted in training new hires
Financial Counselor
Primary Children's Medical Center, IHC
07.1997 - 07.1998
- Worked daily reports: credit, unbilled, payment/adjustment, aging
- Billed commercial insurances
- Made payment arrangements with patients
- Assisted with customer and insurance billing inquiries
- Verified insurance payments are correct
- Ensured the patient received the correct statements
- Sent accounts to collections
- Processed charity applications and requested approval/denial
Main Cashier
Primary Children's Hospital, IHC
04.1996 - 06.1997
- Accepted payments from patients
- Accepted deposits from hospital departments
- Maintained drawer balance
- Maintained Daily Balancing Summary Report
- Prepared bank deposits for pickup
- Back-up for Main Cashier
Education
Some College (No Degree) - CPC/CRC
Completed online courses for CPC and CRC through AAPC.
Did not take exams-uncertified.
GED -
05.1992
Some College (No Degree) - Health Information Management
Skills
- Supervisory Experience
- Project Management
- Proficiency in Office (Excel, Word, etc)
- Facility & Professional Claims
- Medicare & Medicaid Eligibility
- Training Experience
- Interpersonal Skills
- Detail-Oriented
- Excellent Multi-Tasking
- Excellent Communication
- Quick Learner
- Medicare Risk Adjustment
- Office Meetings
- Department Collaboration
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