Beverly Johnson

Claims Analyst with 11+ years of revenue cycle and claims management experience, specializing in inpatient and outpatient denials, appeals writing, contract payment calculations, and medical collections. Demonstrates strong CPT/HCPCS coding knowledge, accounting and analytical skills, and consistent achievement of daily and monthly performance metrics for major clients such as HCA and UPMC. Focused on improving cash flow and reducing AR days through accurate claim resolution, clear payer and patient communication, and collaborative process improvements to support team goals.

Claims Analyst - Trend Health Partners - Nashville, TN

(2022-02)

WFH Position

• Processing and reviewing Inpatient and Outpatient claim denials, from all Major Insurances Completes.
• Writing appeals, processing and posting payments for the facilities.
• Meeting and exceeded client expectations by reaching the daily goals and monthly metrics.
• Consistently checking balances, such as 120 days past due and able to resolve accounts, both on Commercials and Government accounts.
• Our major clients are HCA and UPMC.

Claims Representative - HFRI, LLC - Chicago, IL

(2020-09 - 2022-02)

WFH Position

• Reviewing all denied claims for Underpayments, Overpayments as well as any coding corrections needed; to have the client's claims paid as per contract.
• Responsible for calculating the expected payments by using contract formulas.
• Proficient in meeting the metrics set out by the Company.

Patient Accounts Representative - HCA Healthcare - Nashville, TN

(2018-02 - 2020-07)

WFH Position

• My position as a patient account representative required me to handle all Incoming and Outgoing calls from patients as well as Insurance carriers.
• Daily activities included posting payments, adjustments, discussing balances and handling all mail and correspondence for the patient; all while meeting metrics set by the company.
• Updating all patient's demographics as well as adding Insurance information such as claims address, effective dates, and any other relative updates to assist the billing department; all while using the Epic System.
• This position also required calling on all major Insurance company to obtain the patient's current eligibility and benefits throughout the entire Vanderbilt System.

Verifications Representative / Central Registration - Vanderbilt University - Nashville, TN

(2017-08 - 2017-12)

CONTRACT POSITION

• Updating all patient's demographics as well as adding Insurance information such as claims address, effective dates, and any other relative updates to assist the billing department; all while using the Epic System.
• This position also required calling on all major Insurance company to obtain the patient's current eligibility and benefits throughout the entire Vanderbilt System.

Intake Specialist - Legal Intake Professionals - Nashville, TN

(2017-04 - 2017-10)

• Part time evenings and Overnight Call representative
• Received calls from potential clients who were requesting the advice or assistance of an attorney
• Processed the clients information completely and accurately to the designated attorney
• Handled Medical Malpractice, Slip and fall, Auto Accidents, and Whistle Blowers cases

Medicare Representative - CGS - Nashville, TN

(2017-05 - 2017-08)

CONTRACT POSITION

• As a Medicare contract employee, our team was responsible for clearing up incorrect payments made by Medicare to thousands of providers.
• These edits were made primarily on J codes.
• The claims were then reprocessed correctly and then paid to Physicians and Hospitals.

Outpatient Therapy Verifications Representative - Brookdale Senior Living - Brentwood, TN

(2015-01 - 2017-03)

Private Pay SNF PAR / Collections A/R

• Complete understanding of Outpatient PT/OT/ST Charges, EOB's as well as Medicare/Medicaid/Secondary and Private Pay charges
• Verification of all major insurances, State Medicaid Plans, Tricare/Champ VA. Determining benefits and Coordination of Benefits
• Working closely with the Skilled Nursing and Assisted Living Facilities. Also communicated directly with Site Directors and Therapists of needed.
• Team player and was able to provide past collection experience to the department. My goals were also met within the company as well as being a top performer

Medical Billing and Coding - Fortis Institute (2011-06 - 2012-06)

Certification - Medical Coding - Fortis Institute (2011-08 - 2012-05)