Teonna Johnson
Charlotte,NC
Summary
Highly skilled and well-versed in healthcare and customer service adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life. Strong communicator with passion for helping others.
Overview
13
13
years of professional experience
Work History
Reimbursement Case Manager
CareMetx
05.2023 - Current
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
- Serves as patient advocate and enhances caller/contact experience.
- Collects and review all patient information, degree authorized by SOP of the program.
- Determines patient’s eligibility and conducts patient enrollment activities (example patient assistance programs and copay assistance)
- Extensive knowledge of HIPAA regulations and follows all company policies.
- Performs reimbursement related activities such as benefit investigations, prior authorizations, appeals, etc.
- Managed approximately 30 incoming calls, emails and faxed per day.
Quality Specialist
Atrium Healthcare
02.2018 - 05.2023
- Developed comprehensive quality control documentation, standardizing procedures across all departments and promoting consistency.
- Validates and performs quality review of scanned records as well as monitors and maintains integrity of legal medical record.
- Reviews quality of all images in batch and verifies accuracy of indices assigned.
- Determines readiness of batch for quality control process.
- Identifies trends in scanning errors and processes and communicates to management. Assists with quality review of medical records as appropriate and determined by manager.
- Relocates electronic images that are incorrectly filed in another document or encounter.
- Managed over 1000 pages per batch and faxes per day.
Customer Quality Specialist
AmerisourceBergen
01.2014 - 02.2018
- Maintained up-to-date knowledge of product and service changes.
- Responded proactively and positively to rapid change.
- Trained new personnel regarding company operations, policies and services.
- Trained staff on operating procedures and company services.
- Monitored weekly production and quality standards, training needs, annual reviews and corrective actions requirements.
- Coordinate and monitor daily operations of 80 or more team associates.
- Instrumental in overall weekly audit performance improvement. Audit staff and provide feedback including strengths and areas of improvement in order to maintain performance standards.
Reimbursement Coordinator
AmerisourceBergen
10.2011 - 01.2014
- Improved reimbursement rates with regular audits of insurance contracts to ensure compliance and proper coding practices.
- Established strong relationships with payer representatives, fostering open communication channels that facilitated problem resolution and expedited claim approvals.
- Enhanced reimbursement procedures by streamlining claims submission process and reducing processing time.
- Collaborated with cross-functional teams to develop strategies for maximizing revenue reimbursement opportunities.
- Documenting and initiating prior authorization process, claims appeals, etc.
Education
High School Diploma -
Mallard Creek High School
Charlotte, NCAshford High School
Skills
- Problem-Solving
- Case Management
- Case Documentation
- Organization and Multitasking
Software Skills
- EPIC, SAP, CRM, Canopy, CDI Work Queue, Enterprise, OnBase, Connection
Timeline
Reimbursement Case Manager
CareMetx
05.2023 - Current
Quality Specialist
Atrium Healthcare
02.2018 - 05.2023
Customer Quality Specialist
AmerisourceBergen
01.2014 - 02.2018
Reimbursement Coordinator
AmerisourceBergen
10.2011 - 01.2014
High School Diploma -
Mallard Creek High School
Ashford High School
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