Home Health Manager

832-***-****•************@*****.***

Tammy Johnson

**** ********* **, ******** ****, TX 77459•832-***-****•************@*****.***

Tammy Johnson

Objective

To provide excellent service to patients, members, and providers using my unique skills and expertise.

Experience

06/12 – 04/13

Zenith American Solutions Houston, TX

Participant Services Representative

Assisted members with benefit questions

Assisted members with claims questions

Provided benefits to providers

Enrolled members into insurance plans

Assisted members with understanding of their EOBs

Processed dental claims through Acclaim systems

Processed prescription claims through Acclaim systems

Processed medical claims (outpatient diagnostic, surgical, office visits, and DME) through the EDI

system

Processed over one hundred claims daily

Troubleshoot claim issues

Interacted with Blue Cross and Blue Shield

06/11 – 06/12

Molina Healthcare Houston, TX

Member Service Representative

Answer incoming calls from members, providers, and etc.

Assist members with concerns, request, complaints, and inquires

Assist with education members of plan procedures and benefits

Conduct outbound enrollment verification calls to new members

Assist with satisfaction assessment calls and special projects as needed

Maintain daily outbound education verification reports

Use of QNX and NICE performance manager

Assist providers of procedure of authorizations and appeals processes

03/00 – 07/09

Physical Therapy International Stafford, TX

Billing, Collections, and Contracts Coordinator

Billed and collected from over 300 home health agencies

Set up contracts for new home health agencies in TX, CI, AR, KY, and NC

Verified, collected, and billed private insurance carriers

Daily bank deposits

Provided weekly productivity

Recruited

Resolved billing issues or concerns

Updated professional credentials

06/96 – 03/00

832-***-****•************@*****.***

Tammy Johnson

Texas Orthopedic Hospital Houston, TX

Admitting Representative/Certified Nursing Assistant

Admitted patients for surgery

Input and verified patients’ demographics

Insurance verification

Collected co-pays and deductibles

Assist patients with daily hygiene activities

Daily vital signs

Collected and measured input and output

Prepared fresh linen

Assist with transfers

PBX

Education

08/09 - Present

Houston Community College Houston, TX

Nursing

Associated Degree in the Arts

References

References are available on request.

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