Teja Johnson

Applied claims management expertise to analyze exposure, plan actions, and resolve claims, ensuring proper coverage and payment amounts. Interacted extensively with various parties to ensure effective communication and resolution, documenting all claim-related information. Provided exceptional customer service by exhibiting empathy and ensuring timely payments in accordance with policies and regul

Reviewed, analyzed, and processed tissue transplant claims, ensuring compliance with payer policies, provider contracts, and federal/state regulations. Collaborated with transplant centers and interpreted clinical documentation to determine claim eligibility and resolve discrepancies. Achieved 99% accuracy on high-dollar claims and reduced resolution time by 25% through standardized audit processe

Utilized electronic health records and communication methods to ensure accurate information sharing and patient care coordination, managing Medicare and Medicaid plans. Effectively handled a high volume of incoming calls, providing exceptional customer service and assisting members with billing, PCP changes, and claim reviews. Maintained accountability for accurate data entry and patient privacy a

Provided assistance, answered inquiries, and resolved issues to guarantee the best possible customer experience, handling inbound client requests instantly. Collaborated effectively with colleagues and developed a comprehensive understanding of Aetna products to provide accurate information. Displayed empathy and patience, analyzed issues to find effective solutions, and received the “Customer Ser

Ensured personalized assistance, guidance, and support for every customer, demonstrating excellent interpersonal and communication skills. Assisted members with billing inquiries, primary care physician changes, address updates, and reviewed/documented claims. Awarded “Employee of the Month” multiple times and became a team leader for special projects.