Melissa Johnson
Knoxville
Summary
Insurance professional with strong background in verifying insurance coverage and benefits. Skilled in navigating complex systems, resolving discrepancies, and ensuring accurate information. Known for excellent team collaboration and adaptability to changing needs. Efficient in communication, problem-solving, and maintaining high standards for quality and results.
Overview
27
27
years of professional experience
Work History
New Patient Coordinator/Insurance Verification Specialist
SOUTHEAST SPINE AND PAIN ASSOC.
08.2016 - Current
- Coordinated scheduling for new patient appointments, optimizing clinic workflow and enhancing patient experience.
- Managed patient intake processes, ensuring accurate documentation and compliance with healthcare regulations.
- Facilitated communication between patients and healthcare providers, addressing inquiries and promoting satisfaction.
- Implemented electronic health record management systems to streamline information retrieval and improve data accuracy.
- Oversaw referral processes to specialists, maintaining strong relationships with external partners to ensure seamless care transitions.
- Managed a high volume of inbound calls while maintaining accuracy in appointment scheduling and patient record updates.
- Ensured compliance with HIPAA regulations, protecting sensitive patient information at all times.
- Enhanced patient satisfaction by streamlining appointment scheduling and providing friendly service.
- Provided exceptional customer service, addressing concerns and answering inquiries promptly and professionally.
- Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch.
- Conducted insurance verification to ensure accurate patient coverage and eligibility.
- Collaborated with healthcare providers to resolve complex billing issues efficiently.
- Utilized electronic health record systems to maintain up-to-date patient information.
- Analyzed insurance policies to identify discrepancies and improve claim resolutions.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Minimized delays in treatment scheduling by promptly identifying potential coverage issues and working proactively towards their resolution.
- Supported timely claims processing by submitting accurate and complete documentation to insurance companies.
- Played critical role in financial counseling team, advising patients on insurance-related matters to optimize their healthcare expenditure.
- Enhanced patient satisfaction by providing clear explanations of insurance benefits and coverage.
Health Information Manager
NHC Healthcare
09.1998 - 08.2016
- Led implementation of electronic health record systems to enhance data accessibility and accuracy.
- Developed and enforced health information management policies ensuring compliance with regulatory standards.
- Collaborated with clinical staff to optimize documentation processes, improving workflow efficiency.
- Conducted training sessions for staff on health information protocols and software usage.
- Oversaw medical coding accuracy, ensuring alignment with billing practices and reimbursement guidelines.
- Managed audits of health information to maintain integrity and confidentiality of patient records.
- Followed up with patients about medical and healthcare processes.
- Effectively managed release of information requests, safeguarding patient privacy while adhering to legal requirements for disclosure purposes.
- Attained up-to-date knowledge of coding requirements through continuing education courses and certification renewal.
- Collaborated with healthcare providers to obtain necessary documentation for accurate code assignment and claim submission.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Education
Associate of Applied Science -
Roane State Community College
Harriman, TN12-2014
Skills
- Insurance verification
- Electronic health records
- HIPAA compliance
- Customer service
- Medical billing practices
- Referral coordination
- Coverage issue resolution
- Problem resolution
- Patient scheduling
- Healthcare
- Multitasking
- Critical thinking skills
- Medical terminology
- Insurance practices
- Payment collection
Timeline
New Patient Coordinator/Insurance Verification Specialist
SOUTHEAST SPINE AND PAIN ASSOC.
08.2016 - Current
Health Information Manager
NHC Healthcare
09.1998 - 08.2016
Associate of Applied Science -
Roane State Community College