KEBLENA S. JOHNSON
Orlando,FL
Summary
Results-driven Revenue Cycle Management (RCM) and Accounts Receivable Specialist with 13+ years of experience managing the full revenue cycle for hospital and physician practices. Expertise in insurance follow-up, denial resolution, appeals, payment posting, authorizations, reimbursement analysis, and claims management. Skilled in working with Medicare, Medicaid, and commercial payers while ensuring HIPAA compliance and maximizing reimbursement. Proven ability to thrive in remote environments, manage high claim volumes, and collaborate with cross-functional teams to improve revenue cycle performance.
Overview
1
1
Certification
14
14
years of professional experience
Work History
Accounts Receivable Representative
MedServ
02.2025 - Current
- Manage accounts receivable follow-up to ensure timely reimbursement from commercial and government payers.
- Investigate and resolve claim denials, payment variances, and outstanding balances.
- Contact insurance carriers to resolve reimbursement issues and obtain claim status updates.
- Coordinate medical records and supporting documentation to facilitate claim payment.
- Verify payer compliance with reimbursement policies and contract guidelines.
- Post insurance and patient payments with a high degree of accuracy.
- Balance daily payment batches and reconcile deposits.
- Successfully perform all responsibilities in a fully remote environment while meeting productivity and quality standards.
- Led initiatives to improve accounts receivable processes, resulting in increased efficiency and reduced processing time.
- Evaluated the effectiveness of current credit control measures, recommending changes where needed to minimize risk exposure.
Reimbursement Analyst
Advanced Diabetic Supply
05.2023 - 10.2024
- 003Performed reimbursement analysis for insurance claims and payment discrepancies.
- Investigated and resolved underpayments, overpayments, and account credits.
- Prepared appeals and reconsideration requests to maximize reimbursement.
- Verified authorizations and insurance eligibility prior to claim processing.
- Reviewed clinical documentation, home health visits, and patient charts for billing accuracy.
- Worked with HCPCS and DRG coding concepts to support reimbursement activities.
- Collaborated with providers and insurance carriers to expedite claim resolution.
- Managed book of business in accounts receivable, applying insurance expertise and exemplary customer service.
- Billed and collected for claims submitted on clients' behalf with sales totaling more than a quarter of a million dollars in revenue
Accounts Receivable Representative II
Orlando Health
08.2012 - 04.2023
- Managed high-volume accounts receivable for hospital and physician services.
- Performed insurance follow-up on unpaid and denied claims.
- Resolved billing issues with commercial insurance, Medicare, and Medicaid payers.
- Coordinated with multiple departments to obtain documentation supporting reimbursement.
- Ensured compliance with payer guidelines and organizational policies.
- Posted payments and reconciled daily deposits.
- Maintained productivity and quality standards while working remotely.
- Increased efficiency by automating routine tasks and implementing best practices in accounts receivable management.
- Enhanced cash flow by promptly and accurately processing accounts receivable transactions.
- Maintained strong client relationships through clear communication and timely resolution of disputes.
- Monitored accounts to verify compliance with payment terms and schedules.
- Monitored account aging reports to prioritize follow-ups on overdue accounts.
Education
Associate Degree - Human Services
Columbia College
Orlando, FLMedical Assistant Diploma - undefined
High Tech Institute
Skills
- Epic management
- Experience with GE Centricity software
- Allscripts proficiency
- Strong affinity
- Data analysis proficiency
- Experienced with EncoderPro
- Passport
- Provider and payer portal management
- Microsoft Excel (Pivot Tables)
- Microsoft Outlook
- Microsoft PowerPoint
- Skilled in Microsoft Word document creation
- Experience with Windows environments
- Investigative research
Certification
- HIPAA
- OSHA
CORE COMPETENCIES
- Revenue Cycle Management (RCM)
- Accounts Receivable Follow-Up
- Insurance Verification
- Claims Processing (UB-04 & CMS-1500)
- Denial Management
- Appeals & Reconsiderations
- Payment Posting
- Reimbursement Analysis
- Medical Records Review
- Prior Authorizations
- Referral Management
- Underpayment & Overpayment Resolution
- Medicare, Medicaid & Commercial Insurance
- HIPAA Compliance
- Customer Service
- Data Entry
- Remote Collaboration
- Revenue Recovery
- Patient Account Resolution
Timeline
Accounts Receivable Representative
MedServ
02.2025 - Current
Reimbursement Analyst
Advanced Diabetic Supply
05.2023 - 10.2024
Accounts Receivable Representative II
Orlando Health
08.2012 - 04.2023
Medical Assistant Diploma - undefined
High Tech Institute
Associate Degree - Human Services
Columbia College