Tameika Johnson
Orlando,Florida
Summary
Results driven medical biller with several years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Overview
16
16
years of professional experience
Work History
Medical Billing Specialist
Intellisight LLC/Florida Cardiology PA
Winter Park, FL
02.2023 - Current
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Worked closely with clinical staff to ensure accurate coding practices were followed.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Updated patient accounts with information obtained from internal departments or external sources.
- Provided customer service support to patients who had questions about their bills or payments due.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
- Resolved discrepancies between insurance companies and patients regarding payment of bills.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Collaborated closely with other departments to resolve claims issues.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problems.
- Posted charges, payments and adjustments.
- Reviewed claims for coding accuracy.
- Conducted research on insurance policies, procedures, and regulations to ensure compliance with all applicable laws.
Business Office Lead
Center For Digestive Health
Orlando, FL
11.2015 - 01.2023
- Assisted the Financial Manager with overseeing employees and their job functions, and other duties as requested.
- Assisted employees on the floor with handling patient calls and/or claim billing questions.
- Trained new staff members on software system and the processes of filing and working claims, appeals, and insurance refunds.
- Maintained a positive working relationship with fellow staff and management.
- Answered incoming calls from Billing Queue from both patients and insurance representatives to review claims and discuss the billing of patient accounts.
- Guided employees in handling difficult or complex problems.
- Coordinated communications between patients and insurance carriers.
- Collected, posted, and managed patient account payments.
- Responsible for the Charge Posting for Inpatient/Outpatient procedures, performed by all 8 of the practice's MD providers.
- Backup Charge Poster for Office, ASC, Pathology, and Anesthesia charge entry.
- Verify and enter all demographic and insurance information in patient registration of the EMR software system at the time of charge entry.
- Processed claims and forwarded information to Medicare, Medicare Advantage Plans, Medicaid, and commercial insurance companies.
- Verified and provided patients with their benefits and procedure estimates for upcoming procedure appointments.
- Review insurance EOBs for follow-up actions and research all denials and adjustments.
- Worked directly with the insurance company, healthcare provider, and patient to get claims processed and paid timely.
- Utilize online insurance sites for eligibility and claims status.
- Reviewed and requested patient and insurance credit transfers and refunds, and submitted a valid request to Accounting for approval and processing.
- Responsible for submitting patient statements for all three entities: Provider Office, ASC, and Anesthesia.
- Reviewed and read operative reports for accurate billing.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulations, protocols, and third-party requirements regarding billing.
- Provided leadership in developing and implementing strategies to maximize efficiency and effectiveness of staff members.
Medical Biller/Minor Coder
Associated Billing Service
Apopka, FL
01.2014 - 11.2015
- Minor coder for an Orthopedics, Internal Medicine, Heart, and Vascular practice.
- Responsible for the charge entry for all 3 specialty practice providers, office, and procedure charges by ensuring that correct coding is billed out by reviewing office and operative reports.
- Responsible for all three specialty practice providers' insurance A/R by filing and submitting claims, both electronically and on paper.
- Verified patients' insurance coverage and claims status utilizing online insurance websites and/or utilizing Availity and WebMD.
- Worked claim denials and completed appeals.
- Reviewed medical records to meet insurance company requirements.
- Added modifiers as appropriate, coded narrative diagnoses, and verified diagnoses.
- Interpreted medical reports to apply appropriate ICD-9, CPT-4, and HCPCS codes.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulations, protocols, and third-party requirements regarding billing.
Medical Insurance Specialist
Intellisight LLC/Florida Cardiology PA
Winter Park, FL
08.2008 - 01.2014
- Responsible for managing the practice's Insurance A/R.
- Reviewed claims for accuracy before submitting for billing.
- Review insurance EOBs for follow-up actions and research all denials and adjustments.
- Submitted appeals using provider portals and phone communication.
- Collected patient payments and balanced any daily entry of payments and adjustments to daily reports.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Maintained up-to-date understanding of insurance payment practices.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
Education
Associate of Science - Health Information Technology
Central Florida College
Winter Park, FL2008
Skills
- Microsoft Office and Excel
- Computer Skills
- Gastrology Software Applications Proficiency such as GMed, gGastro ModMed
- Epic Systems
- ICD-10 Coding
- Medical Terminology
- Data Entry
- Electronic Claims Filing
- Read/Code from Operative Reports
- Read and review Insurance EOBs and Denial codes
- Intergy software applications proficiency
- Insurance Verification
- HIPAA Compliance
- Payment posting
- Claims review
- Claims Processing
- CMS-1500 Billing Forms
- Medicaid and Medicare Knowledge
- Customer Service
- Medical coding
Timeline
Medical Billing Specialist
Intellisight LLC/Florida Cardiology PA
02.2023 - Current
Business Office Lead
Center For Digestive Health
11.2015 - 01.2023
Medical Biller/Minor Coder
Associated Billing Service
01.2014 - 11.2015
Medical Insurance Specialist
Intellisight LLC/Florida Cardiology PA
08.2008 - 01.2014
Associate of Science - Health Information Technology
Central Florida College
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