Customer Service

TOMEKA R. JOHNSON

Houston, TX ***** · 832-***-**** · **.*******@*******.***

PROFESSIONAL SUMMARY

Experienced healthcare and personal injury professional with a strong background in medical billing, collecƟons, claim reimbursement, insurance verificaƟon, bill reducƟon and medical records management. Skilled in ICD-9 and 10 coding, EOB review and claims processing. Proficient in electronic medical records, medical and personal injury claims processing across various plaƞorms. Proven ability to manage high-volume tasks in legal, clinical, and call center environments with accuracy and efficiency. SKILLS

• Medical audiƟng

• Medical documentaƟon

• Medical terminology

• ICD-9 and ICD-10 coding

• Private insurance, Medicare and Medicaid

• Insurance verificaƟon

• PaƟent intake coordinaƟon

• Computer

• NegoƟaƟons

• Listening

• Problem Solving

• Customer service

• CommunicaƟons

WORK HISTORY

Remote Employee/ Full-Ɵme/ Temporary Employee June 2021 Della Info tech Staffing Agency- December 2023

• Reviewed subscriber reƟrement health insurance plan and benefits.

• Inbound/ outbound client and provider calling.

• Arranged client payment plans.

• Medical records filing.

• Reviewed healthcare records: dme, personal injury law, home health, and hospital.

• Medical billing: behavioral health, dme, and home health billing.

• Reviewed medical claim submissions.

• Payment collecƟons.

• Verified client insurance benefits.

• Created medical insurance analysis charts.

• Health informaƟon management.

Personal Injury NegoƟator Asst./Medical Bill & Records Specialist The Godsey MarƟn Law Firm- February 2018 to April 2021

• Prepared auto insurance demand leƩers.

• NegoƟated client medical bills: provider bills, hospital liens, insurance and child support liens.

• Inbound/ outbound calls to clients and providers hospitals, various lien holders, and insurance companies.

• Verified client auto insurance benefit.

• Collected client medical records.

• Maintained, sorted, and scanned client medical records.

• Prepared client seƩlement disbursement.

• Appointment seƫng.

Medical Billing Specialist

Community Medical Supply- September 2013 to August 2018

• Billed and submiƩed durable medical equipment claims.

• Private insurance, Medicare and Medicaid billing.

• ExplanaƟon of benefits review.

• Claims management: follow-up, Ɵmely filing, duplicate, rejected, over and under claims payments.

• Resolved billing discrepancies.

• Verified paƟent insurance eligibility and benefits.

• Conducted Medicare evaluaƟon.

• Completed and submiƩed re-determinaƟons claims appeals and authorizaƟon requests.

• Coordinated delivery Ɵckets.

• Organized and set delivery appointments.

• Assisted with filing, faxing and invoicing reports. Medical Billing Specialist

Reliance Billing Services- February 2008 to April 2011

• Billed and submiƩed durable medical equipment claims.

• Private insurance, Medicare and Medicaid billing.

• Invoiced client accounts.

• Created provider billing reports.

• ExplanaƟon of benefits review.

• Claims management: follow-up, Ɵmely filing, duplicate, rejected, over and under claims payments.

• Resolved billing discrepancies.

• Completed and submiƩed re-determinaƟons claims appeals and authorizaƟon requests.

• Inbound/ outbound client and provider calling.

• Appointment seƫng.

• Assisted with filing, faxing and documentaƟon scanning. EDUCATION

The Academy of Healthcare Professionals

Medical Billing and Coding-Houston, TX January 2008

• CerƟficaƟon

Douglas MacArthur High School

Houston, TX- June 1999

• Honor Roll

• Awarded All American Scholar 1999 Vol. 36

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