Sheila Johnson
Phoenix,AZ
Summary
Business-driven professional seeking a position within revenue cycle management, where application of referral, billing and medical experience, education, training, and initiatives for long-term business vision will contribute to the growth of the organization.
Overview
12
12
years of professional experience
Work History
Insurance Coordinator
Optum Infusion
Phoenix, Arizona
12.2019 - Current
- Work from home
- Responsible for initiating referral process
- Clinical Review/Prior Auth Submission
- Managing the admission/discharge of transition of referral
- Working closely with providers/hospitals
- Managing incoming calls/requests from members/providers/insurance company
- Processed payments for insurance premiums and maintained accurate records of all transactions.
- Assist with Appeal for denied PA
- Assist with covering/training teammates
Billing Coordinator
Optum Infusion
Phoenix, Arizona
12.2018 - 12.2019
- Work from home
- Medical, Pharmaceutical and Ancillary Billing
- Billed 65+claims daily while following contractual agreements with insurances
- Manage preparation of invoices, reconciliation of billing with A/R, monitor outstanding balances, taking appropriate action
- Maintained up-to-date knowledge of all applicable laws related to billing activities.
- Coordinate with multiple departments within the organization to ensure effective streamlining of internal processes, contributed to multiple new process implementations
- Analyzed customer accounts to identify discrepancies and resolve billing issues.
Sr. Customer Service Advocate
OptumRx
Phoenix, Arizona
10.2015 - 12.2018
- Mail Order Prescription/Benefits
- Hybrid- Commerical, Medicare, Medicaid
- Taking inbound calls members/providers/pharmacies
- Research/Resolution
- Escalations
- Trained current/new staff members on company policies, procedures, and standards related to customer service.
Customer Service Representative
Avesis
Phoenix, Arizona
01.2012 - 10.2015
- Answered members/provider inquiries and provided accurate information regarding vision/dental benefits.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Took on extra project from Supervisors to assist other teammates
Education
Trade School - Phlebotomy
Brookline College - Phoenix
Phoenix, AZ01-2010
GED -
Brookline College - Phoenix
Phoenix, AZ01-2003
Trade School - Medical Assisting
Brookline College - Phoenix
Phoenix, AZ01-2000
Skills
- Service Referral
- Patient Contact
- Insurance Program Management
- Client Account Management
- Medical Insurance Understanding
- Billing Information Collection
- Prior Authorization Processing
- Healthcare Knowledge
- Claim Referrals Experience
- Patient Management
- Insurance Billing
- Medicare/Medicaid Knowledge
- Data Entry
- Data Coding
- Explaining Policies
- Relationship Building
Languages
English
Professional
References
References available upon request.
Timeline
Insurance Coordinator
Optum Infusion
12.2019 - Current
Billing Coordinator
Optum Infusion
12.2018 - 12.2019
Sr. Customer Service Advocate
OptumRx
10.2015 - 12.2018
Customer Service Representative
Avesis
01.2012 - 10.2015
Trade School - Phlebotomy
Brookline College - Phoenix
GED -
Brookline College - Phoenix
Trade School - Medical Assisting
Brookline College - Phoenix