Sarah Johnson
Reno,NV
Overview
13
13
years of professional experience
Work History
Referral Coordinator
Reno Sparks Tribal Health Center
Reno, NV
07.2023 - Current
- Receive and complete referral orders by ensuring that all relative documentation is in the referral packet, including obtaining prior authorization as needed and then submit all appropriate information to outside specialist offices by electronic and traditional fac
- Maintaining contact with the patient regarding referral and scheduling
- Follow up on referral to obtain scheduling information and obtaining medical records
- Receiving and reviewing authorization request from specialist office for follow up appointments and procedures
- Create prior authorization numbers and purchase order numbers for RSTHC to pay as secondary payer or tertiary payer when appropriate
- Review patient information and determine appropriate criteria is met for RSTHC coverage
- Scan medical records and other documents received from specialist offices by way of fax or utilization of provider portals.
- Write approval writing and denial letters to patients and specialist offices
- maintain professional phone etiquette with patients and specialists.
- EHR System use: Next Gen and RPMS.
- Software use: Microsoft Excel, Word, and Outlook. Shortel.
Insurance and Claims Representative
The Swift Institute
Reno, NV
11.2022 - 07.2023
- Monitor and investigate claim denials with accuracy and completeness to ensure timely claim adjudication in accordance with The Swift Institute policies and healthcare payer rules and regulations
- Utilize work ques for everyday assignments and Microsoft Excel for projects.
- Conduct prompt follow up with insurance companies by phone, secure online messaging, and online payer portals.
- Have thorough understanding of general billing policies such as identifying patients payment responsibilities, coordination of benefits, reading explanation of benefits, and timely filing requirements
- Maintain excellent phone etiquette with patients and insurance companies.
- Communicate efficiently with management regarding claims issues and identify root causes of them
- System use: Athena.
- Software use: Microsoft Excel, Word, and Outlook
Healthcare Coordinator
Pacific Dental Services
Reno, NV
01.2022 - 12.2022
- Schedule and reschedule patient appointments over the phone and in person
- Greet patients in a courteous manner while checking them in and out of appointments
- Build treatment plans, create financial arrangements
- Review claims, EOBs, patient billing information and use work queues to complete pre-registration, appointment requests, and contact patients regarding unsecure and past due billing
- Ability to maintain good communication with doctors, patients, and supervisors
- Maintain well written notes and understand and follow policies and procedures of the office and insurances.
- System use: EPIC
Medical Billing Specialist, CPB
Carbon Health
Remote
07.2021 - 01.2022
- Monitor and investigate claim errors and clearinghouse rejections as well as denials to identify and bring awareness to claims and payer issues
- Understand and comply with Carbon and payer policies and rules and regulations
- Verify insurance and contact patients regarding missing or incorrect insurance information
- Stay on task while working 100% remotely
- Carbon uses their own created EHR system and software.
Insurance and Claims Specialist, CPB
Renown
Reno, NV
04.2016 - 07.2021
- Monitor and investigate claim denials with accuracy and completeness to ensure timely claim adjudication in accordance with Renown policies and healthcare payer rules and regulations
- Work and cross train in a variety of work queues and projects
- Conduct prompt follow up with insurance companies by phone, secure online messaging, and payer portals
- Utilize payer portals for claim information as well as finding Utilization and Management information to assist in appealing denials
- understanding and ability to balance claims and complete accurate and timely appeals
- Communicate efficiently with management regarding claims issues and their root causes
- Assist in education, training, and standard work development (creating and/or updating work flow charts)
- Able and willing to work short notice on projects including those that require extra time in the office
- Continue education as it relates to professional billing
- Ability to stay on task while working remotely
- System use: EPIC
- Software use: Microsoft Teams, Excel, Word, Outlook. Electronic faxing.
Telephone Scheduling
GI Consultants
Reno, NV
08.2014 - 04.2016
- Confirm that referrals are received by electronic fax before scheduling new patient appointments
- Ability to handle heavy call loads (both in and out bound)
- Respond to high amounts of voice messages within a timely manner
- Communicate with multiple departments to ensure smooth workflow and positive patient treatment
- Follow up and maintenance of scheduling wait lists
Contract Health Services
Pyramid Lake Tribal Health Clinic
Nixon, NV
10.2011 - 08.2014
- Receive and complete referral orders by ensuring that all relative documentation is in the referral packet, including obtaining prior authorization as needed and then submit all appropriate information to outside specialist offices by traditional fax
- Maintaining contact with the patient regarding referral and scheduling
- Follow up on referral to obtain scheduling information and obtaining medical records
- Receiving and reviewing authorization request from specialist office for follow up appointments and procedures
- Obtain Indian Health Services (IHS) authorization for every specialist visit
- Review patient information and determine appropriate criteria is met for IHS coverage
- Receive medical records by fax and review for medical plan and submit them to HIM/Medical records department for filing
- Write approval writing and denial letters to patients and specialist offices
- maintain professional phone etiquette with patients and specialists.
- EHR and RPMS.
- Software use: Microsoft Excel, Word, and Outlook.
Patient Registration Clerk
Pyramid Lake Tribal Health Clinic
Nixon, NV
06.2011 - 10.2011
- Greeted patients, ensured appropriate registration paperwork was completed, update patient demographics, obtain and verify insurance information
- scheduled/cancelled/rescheduled appointments in person and over the phone
- Coordinate with transportation department for patient transportation to and from appointments
- Called patients to confirm appointments and obtain additional insurance information as needed
Education
Certified Professional Biller (2018-2021) -
AAPC
Reno, NVH.S. Diploma -
Sparks High School
Sparks, NVSkills
- Type 75 wpm, 10 Key by touch
- 10 years Clerical/Medical office experience
- Appropriate customer service in-person and over the phone
- Efficient in navigating and understanding of policies and procedures
- Great at accessing tools and resources
- Microsoft Word, Excel, PowerPoint, Outlook, Teams
- Knowledgeable in medical terminology, CPT, and ICD
- Professional Billing Certification 2018-2021 (Will re-certify if required)
- Ability to stay on task while working remotely or independently
- Work well with others, especially as part of a team
Timeline
Referral Coordinator
Reno Sparks Tribal Health Center
07.2023 - Current
Insurance and Claims Representative
The Swift Institute
11.2022 - 07.2023
Healthcare Coordinator
Pacific Dental Services
01.2022 - 12.2022
Medical Billing Specialist, CPB
Carbon Health
07.2021 - 01.2022
Insurance and Claims Specialist, CPB
Renown
04.2016 - 07.2021
Telephone Scheduling
GI Consultants
08.2014 - 04.2016
Contract Health Services
Pyramid Lake Tribal Health Clinic
10.2011 - 08.2014
Patient Registration Clerk
Pyramid Lake Tribal Health Clinic
06.2011 - 10.2011
Certified Professional Biller (2018-2021) -
AAPC
H.S. Diploma -
Sparks High School