Shantay Marie Johnson
Summary
Detail-oriented Medical Biller for 15 years & Medical Coder for two years of full-cycle billing experience across commercial, Medicaid, and Medicare payers. Expert in ICD-9/ICD-10/CPT coding, claim denial resolution, and revenue cycle management. Proven track record in pediatric, mental health, and specialty billing with strong patient communication and proficiency in collections.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medical Biller/Coder & Follow-Up Rep
All Care Medical Group
08.2023 - Current
- Manage full-cycle billing and coding for adult, pediatric, mental health, and county clinic visits using ICD-10/9 and CPT.
- Handle claims (commercial and Gov’t payers such as Aetna, BCBS, Optum, OHP)
- Process Vaccine for Children and PCP billing; proficient in Psych E&M and SBIRT coding.
- Conduct patient collections and resolve claims via predictive follow-up, reducing AR.
- Utilized Allscripts EMR to oversee diagnostic coding and billing across multiple specialties.
Collections & Medical Biller
Monitoring Concepts
03.2019 - 08.2023
- Led billing and insurance follow-up for spine, pain management, PT/ST/OT services with major carriers BCBS, Cigna, and UHC.
- Reduced denial rates through detailed coding reviews, CPT, modifiers, and appeals.
- Managed complex back/spinal surgery claims; supported mental health billing; implemented TMHP protocols.
- Managed Medicare and Medicare Advantage billing for WellCare, BCBS Medicare, and Aetna across 30+ clinics using Epic.
Medicaid/Medicare Billing Specialist
Metro Care Services
09.2016 - 02.2019
- Submitted Medicaid/Medicare claims via DDE systems; handled external waivers and collection efforts.
- Specialized in rehabilitation and mental health billing, decreased the denial rate.
- Managed eligibility, authorizations, billing, and collections for Medicaid/Medicare Molina, Superior, PHC, CB.
- Directed office operations, including payroll and intake for two locations; trained billing staff.
Education
B.A. - Psychology
02.2026
Skills
- ICD-9/ICD-10, CPT, HCPCS Coding
- Commercial/Government Payers BCBS, Aetna, UHC, Medicaid, Medicare
- Claim Submission, Follow-up & Denial Management
- Revenue Cycle Management & Collections
- EMR/Billing Systems: Allscripts, Epic, TMHP, Consolo, Psych Consult, Avility, Way Star
- Insurance billing
- Medical billing
- Billing and collection procedures
Certification
- Certified in Adult & Youth Mental Health Training Exp 2027-09
- Certified in Youth Mental Health Training Exp 2027-07
- Trained in Psych E&M and SBIRT Coding
- Project Management Essentials Certified
- Lean Six Sigma White Belt Certified
Timeline
Medical Biller/Coder & Follow-Up Rep
All Care Medical Group
08.2023 - Current
Collections & Medical Biller
Monitoring Concepts
03.2019 - 08.2023
Medicaid/Medicare Billing Specialist
Metro Care Services
09.2016 - 02.2019