Jessica Johnson
Denver,CO
Summary
Detail-oriented CPC, CRC, and CPMA with four years' experience in coding, billing, and auditing medical claims, bills, and documentation within records. Fourteen years' experience in CPT, HCPCS, and ICD-10 coding practices. Skilled in performing compliance audits, identifying coding errors, working appeals and denials, revenue-cycle management and medical coding and billing processes.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Billing Specialist
Woodstock Therapist, LLC-Remote
11.2022 - Current
- Perform credentialing duties related to Illinois Medicaid and Managed Care Organizations.
- Identify, research, and resolve billing variances to maintain system accuracy and currency.
- Prepare itemized statements, bills, or invoices and record amounts due for services rendered.
- Process insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Attain up-to-date knowledge of coding requirements through continuing education courses and certification renewal.
Coder
RCM360-Remote
01.2023 - 01.2024
- Collaborated with healthcare providers and other staff members to ensure accurate documentation and coding.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign CPT and ICD-10 codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Generated reports to identify coding trends and discrepancies.
- Trained and mentored off-shore coders to support growth and development and apply high-quality coding practices.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Performed coding audits to determine accuracy and compliance with coding guidelines.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Verified signatures and checked medical charts for accuracy and completion.
Compliance Officer
Supportive Care-Remote
05.2022 - 01.2023
- Managed four states (approximately 80 providers (LMSW, LCSW, PsyD, PMHNP))
- Assisted with internal and external audits to confirm compliance with applicable laws and regulations.
- Warned violators of infractions or penalties.
- Maintained up-to-date knowledge of applicable laws and regulations.
- Kept informed regarding pending industry changes, trends or best practices.
- Maintained composure in stressful situations, confrontations, interviews and records searches.
- Created and maintained compliant work environment.
- Conducted periodic compliance audits and reviews to identify areas of improvement.
- Educated new and existing providers in coding logic and documentation improvement.
- Educate new and existing providers in coding logic and documentation improvement.
Medical Claims Auditor
Imagine 360-Remote
05.2021 - 05.2022
- Initiated cost containment by conducting thorough audits and data mining
- Researched issues related to claims processing to identify origins and implement corrective solutions
- Reviewed 50-100 insurance claims, daily, against edits (NCCI, MUE, LCD, NCD) and contracts to determine overpayment trends and identify compliance concerns
- Provided high-level professionalism when speaking with customers or responding to emails in order to preserve and promote company's dedication to quality service.
Financial Analyst II
Priority 1, Inc-Little Rock, AR
01.2018 - 05.2021
- Reviewed accounts to assess aging and pursue collection of owed revenue
- Discussed past due status, in a professional manner, with clients and formulated plans to resolve payment
- Identified, researched, and resolved billing variances
- Assisted in preparation of presentations, data tables and other documents for investor meetings.
- Conducted detailed financial analysis to identify and evaluate changes in operations, trends and potential areas of improvement.
- Analyzed client accounts with an in-depth attention to risk exposure
- Managed portfolio of up to $11 million.
Billing Specialist
Dan Lister, MD PA-Heber Springs, AR
02.2015 - 01.2018
- Insurance verifications and obtained prior authorizations as necessary
- Processed EOB/RA and apply insurance payments
- Prepared all billing, submitted to insurance companies, and handled disputes and appeals as needed.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Generated reports to identify coding trends and discrepancies.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Followed exact procedures for handling transfers and other releases of medical records.
- Reviewed medical records for completeness and filed records in alphabetic and numeric order.
- Verified accuracy of patient information in medical records.
Education
Bachelor of Science - Health And Behavioral Science
University of Central Arkansas
Conway, AR05.2012
Skills
- Project Management
- Medical Coding, Billing and Auditing
- Insurance Verification and Prior-Authorizations
- Medical Terminology
- Familiar with many EMR systems
- Anatomy and Physiology
- Medical Records and HIPAA
- CPT, HCPCS, and ICD-10 coding
- Insurance claims analysis
- Revenue Cycle Management
- Workflow Management
- Training and mentoring
Certification
- Certified Professional Coder, 06/01/16, AAPC
- Certified Risk-Adjustment Coder, 12/01/21, AAPC
- Certified Professional Medical Auditor, 12/01/22, AAPC
Timeline
Coder
RCM360-Remote
01.2023 - 01.2024
Billing Specialist
Woodstock Therapist, LLC-Remote
11.2022 - Current
Compliance Officer
Supportive Care-Remote
05.2022 - 01.2023
Medical Claims Auditor
Imagine 360-Remote
05.2021 - 05.2022
Financial Analyst II
Priority 1, Inc-Little Rock, AR
01.2018 - 05.2021
Billing Specialist
Dan Lister, MD PA-Heber Springs, AR
02.2015 - 01.2018
Bachelor of Science - Health And Behavioral Science
University of Central Arkansas
- Certified Professional Coder, 06/01/16, AAPC
- Certified Risk-Adjustment Coder, 12/01/21, AAPC
- Certified Professional Medical Auditor, 12/01/22, AAPC
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