Johna Coney
Ocala,Florida
Summary
Competent Medical Office Administrator with years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Overview
9
9
years of professional experience
Work History
Escalation Supervisor
United Health Group
07.2022 - 06.2024
- Worked closely with healthcare providers to address any documentation issues affecting claim denials
- Educated clinical staff on proper documentation techniques that reduce risk of claim denials due to errors or omissions
- Reviewed and analyzed medical claims for accuracy and completeness
- Confirmed coded data accurately reflected service provided, guarding against fraud, and abuse
- Ensured strict adherence to privacy laws HIPAA when handling sensitive patient information during coding process
- Maintained up-to-date knowledge of coding guidelines, regulations, and reimbursement policies
- Reviewed member medical records for providers to verify diagnosis and procedural data
- Assisted patients with understanding their insurance benefits and financial responsibilities
- Resolved issues related to denied authorizations by providing additional information or appealing decisions.
- Monitored changes in insurance policies, keeping abreast of updates affecting medical billing procedures and informing staff accordingly.
- Contacted insurance companies for patient medical billing operations.
- Developed strong working knowledge of various medical billing software programs, increasing speed and accuracy during data entry processes.
Medical Records Specialist/Billing Specialist
Bowes Imaging Center
01.2015 - 01.2024
- Retrieved patient medical records for physicians, technicians and staff
- Processed requests for information and released information to persons or agencies according to regulations
- Developed and analyzed daily report of missing chart information presented to supervisors
- Resolved discrepancies within patient charts by collaborating with healthcare providers and support staff
- Documented patient encounters for medical records and billing
- Handled medical office billing and insurance verification
- Resolved client billing problems by collecting direct payments and setting up payment plans
- Maintained updated knowledge of medical and mental health diagnoses, disabilities, treatment procedures, common medications and side effects and medical terminology.
- Verified eligibility and compliance with authorization requirements for service providers.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Identified trends in denials through data analysis, adapting strategies accordingly for improved success rates in obtaining approvals.
Authorization Coordinator
Florida Digestive Health Specialists
01.2018 - 07.2022
- Escalated complex or unresolved cases to higher-level management as needed
- Created reports detailing approval rates, denial reasons, and overall trends in authorization process
- Collaborated with billing department to resolve discrepancies in authorized services and payments
- Assisted patients in understanding their insurance benefits and financial responsibilities
- Coach providers on proper entry of EHR's and accurate assignment of A, B, and C codes
- Audit documentation to ensure proper code procedures were followed for reimbursement and prior authorization saving the practice thousands of dollars in months.
- Assisted with financial counseling for uninsured or underinsured patients, connecting them with resources for affordable care options when necessary.
- Reviewed authorizations from payer to determine approved or denied items.
- Acted as a resource for clinical staff, providing guidance on insurance requirements and authorization protocols.
- Participated in regular audits of authorization files, addressing discrepancies and implementing corrective actions as needed.
- Provided exceptional customer service to patients, addressing their concerns related to insurance coverage and authorizations promptly and empathetically.
Education
Associate of Science - Health Administration
University of Cincinnati
Cincinnati, OH06.2025
Associate of Science - Cancer Registry Management
University of Cincinnati
Cincinnati, OH06.2025
Skills
- Database Maintenance
- Collections Management
- Customer Service
- Medical Billing Familiarity
- HIPAA Compliance
- Time Management
- Insurance Verification
- Patient Scheduling
- Medical Charting
- EMR / EHR
- Insurance Claims
- Medical Terminology
- Records Management
- Data Entry
- Dispute Resolution
- Organizational abilities
- Appeals Process Proficiency
- Medical coding knowledge
- Claims adjustment
Timeline
Escalation Supervisor
United Health Group
07.2022 - 06.2024
Authorization Coordinator
Florida Digestive Health Specialists
01.2018 - 07.2022
Medical Records Specialist/Billing Specialist
Bowes Imaging Center
01.2015 - 01.2024
Associate of Science - Health Administration
University of Cincinnati
Associate of Science - Cancer Registry Management
University of Cincinnati
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