Customer Service High School

Devonna Johnson

*** ******** **** #*

Hayward, California 94544

Phone: 510-***-****

Qualifications:

** **** ***** ** ********** in the healthcare field utilizing a hospital patient accounting system,

electronic claims management, and an understanding of billing regulations.

Basic bookkeeping principles, general business procedures, knowledge of registration, collection,

and billing rules and procedures.

Medical terminology, ICD9, CPT4, HCPCS, and coding expertise.

Knowledge Government, Commercial, and Worker's Comp. billing and collections/follow-up

experience.

Working knowledge of hospital information systems and electronic Billing Software.

Knowledge of how to read and interpret insurance billing and coverage bulletins, HIPAA, ABN,

MSP and other payer regulations, remittance advises and explanation of benefits.

Knowledge of managed care including contract analysis and confirmation of correct

reimbursements.

Employment:

Stanford Healthcare

Patient Access Representative 06/23/14 – Present

I am responsible for completing patient admission and registration functions for Radiology & Labs

by identifying patients’ insurance coverage or other financial resources to pay for medical care and

services, assist with patient concerns regarding insurance benefits and payor specific requirements. In

addition, I handle all routine customer service concerns and issues. My job also requires that I process

necessary admission/registration paperwork and obtain necessary documents for billing and compliance

requirements.

Government Biller 06/13/2013 – 06/20/2014

Bill claims to governmental payers & resolve all edits for clean claim submission. Performed collection

attempts on underpaid and denied claims while maintaining clear and concise documentation of collection

process. I maximized reimbursement potential by attaining assigned collection goals & contacting

insurance companies and governmental payers to verify COB and eligibility. I posted adjustments when

applicable & according to the Remittance Advices. Departmental goals were always met individually &

collectively.

Lighthouse Management Inc.

Patient Account Representative 08/27/12 – 06/13/2014– Contract Position with Stanford Healthcare

I followed up on Commercial claims by resolving eligibility issues relating to claims received. Generated

emergency reports/authorizations for all claims received that lacked prior authorization. Adjudicated third

party liability and coordination of benefit claims in accordance with policy. Submitted appeals for

underpaid & denied claims per as per Plan Contracts, provider pricing, member eligibility, referral

authorization procedures, & benefit plans. In addition, I identified trends that would have minimized

maximum collection by creating spreadsheet & submitting to specific contact.

Daughters of Charity

Patient Account Representative -08/14/2002 – 09/23/2010

As a successful account representative I accurately performed account follow-up by processing all types

of contract billing claims for the hospital and hospital-based physicians. Also performs a variety of clerical

duties in order to settle patient accounts quickly. Identified and performed adjustments to correct the

following: erroneous charges, contractual write offs, and other adjustments deemed necessary and

appropriate. Collection were secured through written and oral communications, use of computerized

systems and other technique accepted within the Health care Industry and in accordance with accepted

legal practice. I routinely researched charges and payments on all accounts to assure that the account

reflect correct and current charges and outstanding balances. In addition, I worked closely with our

attorney by referring accounts for assignment after all steps have been made to recover payments with

little or no resolution.

Education:

Castlemont High School, Oakland, CA – Graduated with general diploma 06/1986

Merritt College, Oakland, CA – Graduated with A.A in Social & Behavioral Science 05/2012

Familiar Software:

Epic, Centricity, Mysis, DDE, Net Med, AS400, Chartmax, Meditech, Deliverex, Med Assets, Microsoft

Outlook, Word, and Excel.

REFERENCES ARE AVAILABLE UPON REQUEST

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