Montrice Johnson
Atlanta,GA
Summary
Accomplished and results driven business professional offering successful experience in driving business success in project management, client account management, and business process improvements to increase efficiency and profitability. Recognized as a goal-oriented business-minded professional who consistently delivers results that exceed employers’ expectations.
Overview
16
16
years of professional experience
Work History
Front Desk Insurance Coordinator
Colony Square Dental Associates
Atlanta, Georgia
02.2023 - Current
- Greets, responds quickly and effectively to needs of patients and guests
Responsible for managing patient schedules and direct patient flow
Understanding treatment plans
Coordinate with insurance companies to ensure claim completion
Ensure records are stored securely and in compliance with privacy regulations while maintaining a professional appearance and functionality of office
Processing and submitting insurance claims daily
Monitoring and following up on outstanding claims
Provide the appointment coordinator with patient names and amounts due, so effective collection over the counter can take place during the day
Identify patients in the daily schedule who are a financial concern, note payment problems on the patient’s chart, and arranges a conference with them either before or at the time of the appointment
Record all financial discussions with patients in their file
Prepare and mails patients’ statements each month on a regular billing cycle
Providing insurance predetermination documentation to patients, contacts the patient to make financial arrangements, and schedules treatment
Correspond with insurance companies to resolve payment delays, requests for additional information, or to discuss denied treatment coverage
responsible for running and monitoring weekly and monthly reports to verify insurance payments received, and upload completed insurance forms into patients' electronic files.
Patient Access / Intake Coordinator
Soleo Health
Norcross, GA
02.2022 - 02.2023
- Responsible for receiving and coordinating all referrals into CPR+, include notification of insurance providers for prior authorization and services covered
- Responsible for the review of daily logs and notes from Case Managers to assure continuity of care, documentation of nursing process, appropriateness of intervention/action and timeliness of documentation
- Using discretion and independent judgment in handling patient or physician complaints received, documents and forwards to appropriate administrative staff
- Responsible for maintaining supply inventory as well as daily distribution of supplies to field staff
- Maintains log and any reports essential for appropriate billing and reorder process
- Communicates with Branch Manager any information received from physician, patient or employees about the patients care or needs
- Takes physician orders by phone, documents in database, notifies appropriate Case Manager and adjusts schedules accordingly as indicated
- Files all office records as necessary
- Proficient with data entry, and computer skills for generation of daily office communication
- Provide direct patient care on an as-needed basis, as assigned by direct supervisor
- Assists with other functions as assigned by direct supervisor.
Grievance and Appeals Analyst
Anthem / Contract
12.2021 - 04.2022
- Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language
- Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review
- HMO, POS, PPO, EPO, CDHP, and indemnity related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and regulatory grievances
- Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information
- Serves as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.
Benefits Coordinator
Delta Dental
10.2017 - 12.2021
- Directly responsible for responding to basic telephone, electronic, and written inquiries from dental/vision professionals, groups, subscribers, and brokers while expediently accessing reference materials to analyze and determine appropriate responses to telephone, electronic, and written inquiries
- Communicated clearly basic eligibility, benefits, and claims status and forwards specific inquiries as directed for priority resolution
- Accurately completing online/hardcopy forms and routes to the appropriate department
- Documenting each customer encounter or resolution in the appropriate computer tracking system while identifying, reports and documents system discrepancies
- Met and maintained production standards, counts, and inquiry response turnaround times and participated in training programs while providing support to other departments as directed
- Addressed members/providers/groups eligibility, benefits, insurance plans and claims
- Performed multiple duties besides benefits such as Correspondence, special projects and analyzing internal operations of Delta Dental
- Works closely with project management creating and delivering reports on new operation strategies that cab impact the company’s long-term growth.
Office manager
GA Lock & Key
02.2008 - 09.2017
- Was recruited to assist in the development of new business opportunities to meet trends, implement strategic sales plans, train & dispatch staff, and contribute to all revenue enhancing activities for the organization
- Responsible for receiving 50- 75 inbound calls of customer home and car lockouts to prospective business clients on the spot achieving a 98% closing rate for rekeys, changing locks and new installations over a tri-state area
- Directed and led 14 technicians to ensure clients’ needs were met, while empowering and mentoring them in their success
- Resulting in over $1 million dollars in revenue
- Prospected new clients, built, developed and managed B2C clients, and customer relationships
- Managed all administrative tasks to include payroll, bank runs, and ensured committed delivery times were scheduled and met, reporting service failures, and services compliances with all technicians work orders to stay current with client needs, competition and industry trends.
Education
Sanford Brown College Degree in Medical Assistant -
05.2012
Skills
- Leadership Management
- Project Management
- Problem Solving
- Time Management
- Training & Development
- Professionalism
- Analytical Skills
- Teamwork
- Strategic Thinking Skills
- Accounts Receivable
- Account Management
- Insurance Verification
Timeline
Front Desk Insurance Coordinator
Colony Square Dental Associates
02.2023 - Current
Patient Access / Intake Coordinator
Soleo Health
02.2022 - 02.2023
Grievance and Appeals Analyst
Anthem / Contract
12.2021 - 04.2022
Benefits Coordinator
Delta Dental
10.2017 - 12.2021
Office manager
GA Lock & Key
02.2008 - 09.2017
Sanford Brown College Degree in Medical Assistant -
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