TAWANA JOHNSON
RALEIGH,NC
Summary
Experienced Financial Counselor and Administrative Assistant professional with strong, support, leadership and relationship-building skills.
Overview
29
29
years of professional experience
Work History
FINANCIAL CARE COUNSELOR
PRE-VISIT COLLECTIONS AND ESTIMATES (REMOTE)
10.2022 - Current
- Create, validate and finalize pre-visit estimates for patient's upcoming services.
- Update the billing system to reflect the insurance status of the patient.
- Analyze insurance coverage and benefits for service to ensure timely reimbursement.
- Answer incoming patient calls to discuss estimate(s), insurance coverage(s), payment or direct patient to the appropriate department.
- Explain bills according to Duke Patient Revenue Management Organization credit and collection policies.
- Facilitate payment sources for uninsured patients.
- Calculate and collect cash payments appropriately for all patients via Sycurio.
- Implement appropriate collection actions and assist financially responsible persons in arranging payment.
- Explain policies and procedures, and resolves problems.
- Participate in assigned validation projects for estimate automation.
- Identify and report inconsistencies with estimation templates to department supervisor to escalate to IT for research and resolution.
- Reconcile daily cash deposit.
- Attend weekly and monthly departmental meetings.
- Contribute to a positive work environment by collaborating effectively with colleagues and maintaining open lines of communication across departments.
- Achieve high levels of satisfaction among clientele by consistently providing professional, empathetic, and results-driven support.
- Manage sensitive client information with utmost discretion, ensuring compliance with privacy regulations.
PATIENT REGISTRATION REPRESENTATIVE (SUPPLEMENTAL)
WAKEMED EMERGENCY DEPARTMENT
05.2019 - Current
- Provide comprehensive registration for customers presenting to the Emergency Department with medical emergencies.
- Prioritize workload in a fast-paced environment, delivering unsurpassed customer service to patients and families in stressful situations.
- Answer telephone calls to offer office information, answer questions, and direct calls to staff.
- Maintain patient confidentiality by adhering to HIPAA regulations and securing sensitive information.
- Assists with training new hires on best practices for managing various aspects of the registration process including collecting sensitive information, navigating software systems, and maintaining confidentiality.
- Accurately input patient and insurance information into company's computer system using EPIC.
- Collect payments and co-pays from customers using large variety of insurance programs, adjusting amounts based on specific plan directives.
- Support the hospital's commitment to outstanding patient care by adhering to all policies and procedures related to registration processes.
- Enhance patient satisfaction by providing clear communication, answering queries, and addressing concerns in a timely manner.
- Maintain visible position in Emergency Department lobby
- Greet arriving patients, gathering pertinent data for proper patient identification, placing identification band on patient, and maintains regulatory compliance.
- Engages the triage nurse immediately for patients presenting with cardiac complaints, stroke symptoms, and other emergencies.
- Collect financial and demographic information, verifying active insurance for maximum reimbursement, obtaining signatures for general consent, and scanning documents into the electronic medical record.
FINANCIAL CARE COUNSELOR
DUKE RALEIGH SAME DAY SURGERY
09.2021 - 10.2022
- Analyzed insurance coverage and benefits for service to ensure timely reimbursement.
- Obtained all Prior Authorization Certification and/or authorizations as appropriate.
- Facilitated payment sources for uninsured patients.
- Determined if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
- Admitted, registered and pre-registered patients with accurate patient demographic and financial data.
- Resolved insurance claim rejections/denials and remedy expediently.
- Calculated and collected cash payments appropriately for all patients.
- Reconciled daily cash deposit.
- Evaluated diagnoses to ensure compliance with the Local Medicare Review Policy.
- Performed those duties necessary to ensure all accounts are processed accurately and efficiently.
- Compiled departmental statistics for budgetary and reporting purposes.
- Explained bills according to PRMO credit and collection policies.
- Implemented appropriate collection actions and assist financially responsible persons in arranging payment.
- Informed attending physician of patient financial hardship.
- Completed the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level.
- Updated the billing system to reflect the insurance status of the patient.
- Greeted and provided assistance to visitors and patients.
- Explained policies and procedures, and resolves problems.
- Gathered necessary documentation to support proper handling of inquiries and complaints.
- Assisted with departmental coverage as requested.
- Obtained authorizations based on insurance plan contracts and guidelines.
- Documented billing system according to policy and procedure.
- Entered and updated referrals as required.
- Communicated with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment.
- Managed sensitive client information with utmost discretion, ensuring compliance with privacy regulations.
- Achieved high levels of satisfaction among clientele by consistently providing professional, empathetic, and results-driven support.
- Contributed to a positive work environment by collaborating effectively with colleagues and maintaining open lines of communication across departments.
FINANCIAL CARE COUNSELOR
DUKE HERITAGE PT, OT AND LAB DEPARTMENTS
09.2018 - 09.2021
- Greeted and provided assistance to visitors and patients.
- Scheduled patients for physical therapy, occupational therapy and lab appointments
- Updated the billing system to reflect the insurance status of the patient.
- Analyzed insurance coverage and benefits for service to ensure timely reimbursement.
- Obtained authorizations based on insurance plan contracts and guidelines.
- Documented billing system according to policy and procedure.
- Entered and updated referrals as required.
- Communicated with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment.
- Determined if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
- Informed attending physician of patient financial hardship.
- Checked-in patients with accurate patient demographic and financial data.
- Calculated and collected cash payments appropriately for all patients.
- Reconciled daily cash deposit.
- Performed those duties necessary to ensure all accounts are processed accurately and efficiently.
- Explained bills according to Duke Patient Revenue Management Organization credit and collection policies.
- Implemented appropriate collection actions and assisted financially responsible persons in arranging payment.
- Completed the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level.
- Explained policies and procedures, and resolves problems.
- Gathered necessary documentation to support proper handling of inquiries and complaints.
- Assisted with departmental coverage as requested.
- Managed sensitive client information with utmost discretion, ensuring compliance with privacy regulations.
- Achieved high levels of satisfaction among clientele by consistently providing professional, empathetic, and results-driven support.
- Contributed to a positive work environment by collaborating effectively with colleagues and maintaining open lines of communication across departments.
PATIENT SERVICE ASSOCIATE
DUKE RALEIGH CANCER CENTER
11.2017 - 09.2018
- Prepared for clinic visits by reviewing next day patients and explain billing to patients.
- Answered telephone, received and delivered messages to physicians, nurses and check-out ancillary service requisitions.
- Scheduled tests and procedures.
- Completed and distributed according to Duke Patient Revenue Management Organization credit and collection policies.
- Made return appointments by scheduling patients into the encounter forms.
- Completed preparation of next day activities.
- Entered pre-visit orders and prepare new patient charts.
- Collected X-rays, office charts, medical records, reports, petty cash and collections bag.
- Filed history sheets, ancillary reports and all other required patient record documentation.
- Returned medical records.
- Attached HIPPA/Medicare documents to the Check-in patient upon arrival in the practice.
- Identified correct patient information in Maestro Care.
- Verified patient demographic data.
- Edited Maestro Care as needed.
- Accurately identified the appropriate account for patient visit.
- Presented and educated patients on required forms and obtain signature as required by policy and procedure.
- Completed all Maestro Care check-in files and manage all appropriate alerts.
- Collected and posted co-payments and balances on accounts due.
- Imprinted all patient specific chart documents and requisition/transmittal documents.
- Copied, filed and distributed insurance cards as indicated by procedure.
- Coordinated all labs/procedures as requested.
- Maintained private physician office charts.
LEGAL OFFICE MANAGER
RELIANT REALTY SERVICES LLC
05.2016 - 07.2017
- Managing day-to-day department operations, drafting legal pleadings, liaising between clients and attorneys, training and evaluating staff, etc.
PARALEGAL
PETER COOPER VILAGE/STUVYESANT TOWN
04.2014 - 05.2016
- Gatekeeping incoming legal calls, generating and preparing legal documents, coordinating evictions, maintaining court calendar, etc.
CLAIMS SPECIALIST
LOCAL 32 B-J HEALTH FUND
09.1995 - 08.2002
- Reviewing and approving medical claims, conducting patient intake, assisting in projects, etc.
Education
HEALTHCARE CODING CERTIFICATE COURSE
WAKE TECHNICAL COMMUNITY COLLEGE
RALEIGH, NC07.2024
HEALTHCARE BILLING CERTIFICATE COURSE
WAKE TECHNICAL COMMUNITY COLLEGE
Raleigh, NC07.2022
MEDICAL TERMINOLOGY CERTIFICATE COURSE
WAKE TECHNICAL COMMUNITY COLLEGE
Raleigh, NC12.2021
PARALEGAL STUDIES
The Washington Online Learning Institute
New City, NY04.2013
Non-Degree - LIBERAL ARTS
CUNY Medgar Evers College
New York City, NY01.2009
Non-Degree - COMPUTER INFO SYSTEMS/PUBLIC ADMINISTRATION
CUNY John Jay College of Criminal Justice
New York City, NY01.1996
Skills
- EPIC systems
- Sound judgment
- Calm under pressure
- Exceptional communication skills
- Understands confidentiality
- Ability to work independently
- Team-oriented
- Case management
- MS Word and Excel
- Appointment setting
- Office management
- Supervision and training
Timeline
FINANCIAL CARE COUNSELOR
PRE-VISIT COLLECTIONS AND ESTIMATES (REMOTE)
10.2022 - Current
FINANCIAL CARE COUNSELOR
DUKE RALEIGH SAME DAY SURGERY
09.2021 - 10.2022
PATIENT REGISTRATION REPRESENTATIVE (SUPPLEMENTAL)
WAKEMED EMERGENCY DEPARTMENT
05.2019 - Current
FINANCIAL CARE COUNSELOR
DUKE HERITAGE PT, OT AND LAB DEPARTMENTS
09.2018 - 09.2021
PATIENT SERVICE ASSOCIATE
DUKE RALEIGH CANCER CENTER
11.2017 - 09.2018
LEGAL OFFICE MANAGER
RELIANT REALTY SERVICES LLC
05.2016 - 07.2017
PARALEGAL
PETER COOPER VILAGE/STUVYESANT TOWN
04.2014 - 05.2016
CLAIMS SPECIALIST
LOCAL 32 B-J HEALTH FUND
09.1995 - 08.2002
HEALTHCARE CODING CERTIFICATE COURSE
WAKE TECHNICAL COMMUNITY COLLEGE
HEALTHCARE BILLING CERTIFICATE COURSE
WAKE TECHNICAL COMMUNITY COLLEGE
MEDICAL TERMINOLOGY CERTIFICATE COURSE
WAKE TECHNICAL COMMUNITY COLLEGE
PARALEGAL STUDIES
The Washington Online Learning Institute
Non-Degree - LIBERAL ARTS
CUNY Medgar Evers College
Non-Degree - COMPUTER INFO SYSTEMS/PUBLIC ADMINISTRATION
CUNY John Jay College of Criminal Justice
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