Kameshia Johnson
Arlington,USA
Summary
Experienced medical professional with over 10 years in medical office environments, focused on enhancing patient care and operational efficiency. Skilled in administrative and communication functions that facilitate effective interactions between patients and healthcare providers. Committed to supporting high-quality care and innovative technology while fostering a positive patient experience.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Insurance Verification Specialist
Akumin Imaging
Dallas, TX
01.2024 - Current
- Facilitated initiation of prior authorization processes for diagnostic radiology images, including CT scans, MRIs, and ultrasounds.
- Oversaw daily mammogram and DEXA scan operations at multiple locations throughout South Florida. Coordinated patient workflows and ensured efficient scheduling for imaging services. Facilitated collaboration among healthcare professionals to enhance patient outcomes.
- Manage oversight of HMO PCP referrals for Humana/Careplus ..Healthsun and BCBS patients.
- Facilitated Communication with medical offices to ensure timely authorization submissions.
- Collaborate with insurance providers precertification patient benefits and adherence to policy protocols.
- Utilization of proper system management portals for precert inquiries and processing.
- Management of incoming emails from patient coordinators regarding authorization updates in Microsoft Outlook
- Streamline patient chart access through ERAD and INFINX to enhance workflow efficiency.
- Leverage Ring Central for call handling of Inbound and Outbound communications and electronic faxes.
- Daily use Microsoft Excel to systematically record and analyze daily productivity metrics.
- Verification of ICD-10 and CPT Codes for accuracy in maintaining compliance with coding standards for effective Billing and Claims Processing.
- Manage Correspondence regarding Insurance Denials and Appeals for timely resolution.
- Aid Supervisor with team assignments for efficient role execution in various areas/and or departments.
Contact Center Specialist II
Baylor Scott & White Health
Midlothian, TX
05.2021 - 12.2023
- Handled inbound phone calls, emails, and electronic requests to effectively address and resolve customer inquiries and concerns.
- Utilized optimal methods and tools to furnish customers with accurate and thorough information.
- Assessed emergent health situations through caller information and orchestrated immediate triage efforts.
- Streamlined scheduling and communication of appointment details and financial information to ensure timely arrivals.
- Oversaw accurate creation of new accounts within electronic medical record system.
- Drafted and delivered communications on behalf of patients, caregivers, and healthcare professionals to clinic administrative and provider staff.
Surgical Scheduling/Charge Entry Clerk - MSO Orthopedics/Trauma
Healthcare Employment
Tyler, TX
11.2016 - 05.2021
- UT Health East Texas, Tyler Texas
- Coordinated and scheduled surgeries, follow-up appointments, and additional tests as ordered by surgeon to optimize patient care
- Organized surgical procedure data log daily to ensure accurate tracking and reporting
- Coordinated arrangements for surgical assistants and special equipment.
- Function as liaison between surgeon, OR scheduler/system, and patient
- Served as liaison between surgeon, OR scheduler/system, and patient to facilitate effective communication and scheduling
- Performed coding for ICD-10 and CPT procedures to ensure accurate billing.
- Managed pre-certification process for insurance and confirmed patient eligibility for services.
- Processed surgery prepayments and entered data accurately into the system.
- Coordinated outgoing referrals for physical therapy, home health, and physician consultations.
- Obtained prior authorizations for surgical procedures and injectable medications.
Claims Negotiations Specialist
Multiplan
Arlington, TX
09.2014 - 08.2016
- UT Health East Texas, Tyler Texas
- Coordinated and scheduled surgeries, follow-up appointments, and additional tests as ordered by surgeon to optimize patient care
- Organized surgical procedure data log daily to ensure accurate tracking and reporting
- Coordinated arrangements for surgical assistants and special equipment.
- Function as liaison between surgeon, OR scheduler/system, and patient
- Served as liaison between surgeon, OR scheduler/system, and patient to facilitate effective communication and scheduling
- Performed coding for ICD-10 and CPT procedures to ensure accurate billing.
- Managed pre-certification process for insurance and confirmed patient eligibility for services.
- Processed surgery prepayments and entered data accurately into the system.
- Coordinated outgoing referrals for physical therapy, home health, and physician consultations.
- Obtained prior authorizations for surgical procedures and injectable medications.
Medical Records Clerk
HIM
Tyler, TX
09.2013 - 01.2014
- Entered emergency room charges to maintain accurate patient billing and records
- Scanning of pathology reports, consultations and appeals
- Scanned pathology reports, consultations, and appeals to ensure timely access to critical patient information
- Configured daily production statistics log for tracking purposes
- Prioritize patient daily care according to acuity and scheduled patient procedures
- Daily production stat log configuration
Surgery Scheduling Coordinator
John Peter Smith Hospital
Fort Worth, TX
12.2012 - 08.2013
- Scheduled surgeries, follow-up appointments, and additional tests based on surgeon's orders
- Coordinate and schedule appointments for surgeries and follow-up appointments and any other tests as ordered by the surgeon
- Coordinated arrangements for surgical assistants and special equipment for surgeries
- Organized the daily schedule for surgeries, ensuring all appointments were timely and correctly allocated. and ensure that there are no physician or equipment conflicts
- Function as liaison between surgeon, OR scheduler/system, and patient
- Act as primary contact for surgical patients and respond to telephone inquiries
Office Assistant
Trinity Mother Frances
Tyler, TX
01.2011 - 07.2012
- Performed ICD-9-CM coding and verified CPT coding accuracy
- Conducted verification of patient insurance eligibility to ensure coverage for medical services.
- Maintained patient medical records
- Scheduled patient appointments and managed confidential inquiries
- Identified and collected patient copay and coinsurance payments
- ICD-9-CM coding and verification of CPT coding
Customer Support Representative
CenturyLink Telecommunications
Athens, TX
03.2004 - 07.2010
- Managed and maintained customer accounts to ensure satisfaction and retention
- Responded to customer inquiries, providing accurate information and solutions to enhance experience
- Addressed and resolved customer conflicts to improve service quality.
- Contract/bill interpretation
- Achieved company quality and production standards and received Certification of Excellency Customer Accommodation.
Receptionist
Lakeland Medical Associates
Athens, TX
08.1997 - 08.2003
- Performed ICD-9-CM coding and verified CPT coding for accurate billing
- Performed insurance verification to ensure accurate billing and patient care
- Maintained organized medical records to ensure compliance and easy access
- Scheduled patient appointments and responded to confidential requests efficiently
Education
Certification - Medical Coding and Billing
East Texas Career Training Center
12-2010
High School Diploma - undefined
Athens High School
Business Administration Studies
Trinity Valley Community College
01-1999
Skills
- Urgent needs assessment
- Medical Billing
- Telecommunication systems
- Anatomy knowledge
- Hospital experience
- ICD-10
- Injection administration
- Medical Coding
- Document management
- Administrative support
- Email management
- Medical Terminology
- Assessment of urgent needs
- Patient appointment coordination
- Telecommunications expertise
- Medical office management
- Medical Records
- Epic
- Data entry
- Computer literacy
- Microsoft Outlook
- Outlook
- Receptionist
- Phone etiquette
- Reliability
- Team Work
- Data management
- Computer literacy
- Client relations
- Telephone communication
Certification
- CCPS Medical Coder ID# 215652
- Medical Coding Certification
Summary of System Qualifications
- AS400 Systems
- One Chart
- RAS Systems
- EPIC
- Centricity
- Encoder Pro
- Microsoft Excel/ Outlook
- Next Generation/Enterprise EHR
- Willing to relocate to Dallas-Fort Worth, TX, Arlington, TX or Mansfield, TX
Timeline
Insurance Verification Specialist
Akumin Imaging
01.2024 - Current
Contact Center Specialist II
Baylor Scott & White Health
05.2021 - 12.2023
Surgical Scheduling/Charge Entry Clerk - MSO Orthopedics/Trauma
Healthcare Employment
11.2016 - 05.2021
Claims Negotiations Specialist
Multiplan
09.2014 - 08.2016
Medical Records Clerk
HIM
09.2013 - 01.2014
Surgery Scheduling Coordinator
John Peter Smith Hospital
12.2012 - 08.2013
Office Assistant
Trinity Mother Frances
01.2011 - 07.2012
Customer Support Representative
CenturyLink Telecommunications
03.2004 - 07.2010
Receptionist
Lakeland Medical Associates
08.1997 - 08.2003
High School Diploma - undefined
Athens High School
Business Administration Studies
Trinity Valley Community College
Certification - Medical Coding and Billing
East Texas Career Training Center