Johna Coney
Ocala,Florida
Summary
Driven medical billing and coding professional with a proven track record, adept in database maintenance and offering exceptional customer service. Excelled in improving authorization approval rates by leveraging in-depth knowledge of medical terminology and coding, alongside strong organizational abilities, significantly enhancing operational efficiency.
Overview
10
10
years of professional experience
Work History
Charge Entry Specialist/Transaction Analyst
HCA Healthcare Inc.
Ocala, FL
02.2024 - Current
- Provided support to other teams within the billing department when needed.
- Responded promptly to inquiries from patients, payers, or other external parties concerning billing issues.
- Maintained daily logs of charges entered into the system.
- Generated electronic remittance advice files from payer websites or clearinghouses for reconciliation purposes.
- Maintained current knowledge of changes in healthcare industry standards related to charge entry.
- Assisted with preparation of monthly reports related to charge entry activities.
- Resolved issues with rejected claims in a timely manner.
- Entered data regarding patient demographics, diagnoses, treatments, procedures, and charges accurately into billing systems.
- Created new accounts in the billing system as requested by providers or office staff members.
- Audited medical records for completeness prior to entering charges into the system.
- Processed credit balance refunds according to established guidelines.
Escalation Supervisor
United Health Group
07.2022 - 02.2024
- 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.
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.
Medical Records Specialist/Billing Specialist
Bowes Imaging Center
01.2015 - 12.2017
- 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.
Education
Associate of Science - Health Administration
University of Cincinnati
Cincinnati, OH06.2025
Skills
- Database Maintenance
- Customer Service
- Medical Billing Familiarity
- HIPAA Compliance
- Time Management
- Insurance Verification
- Medical Charting
- EMR / EHR
- Insurance Claims
- Medical Terminology
- Records Management
- Data Entry
- Dispute Resolution
- Organizational abilities
- Appeals Process Proficiency
- Medical coding knowledge
- Claims adjustment
- Charge capture proficiency
- Insurance verification
- Medical billing procedures
Timeline
Charge Entry Specialist/Transaction Analyst
HCA Healthcare Inc.
02.2024 - Current
Escalation Supervisor
United Health Group
07.2022 - 02.2024
Authorization Coordinator
Florida Digestive Health Specialists
01.2018 - 07.2022
Medical Records Specialist/Billing Specialist
Bowes Imaging Center
01.2015 - 12.2017
Associate of Science - Health Administration
University of Cincinnati
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