Tonja Johnson Email & Phone Number

Atlanta

Liaison between Stratose and providers to address questions regarding repricing claim status, program participation and demographic updates. Maintain HIPAA guidelines with business units. Attempt first call resolution through provider education on both inbound and outbound calls. Troubleshoot system applications for clients when necessary.Service Member Relations Line which includes answering inbound calls in a positive and confident manner, while utilizing various Stratose proprietary systems to gather and deliver accurate information. Serve as first point of contact for all inbound and outbound provider communications both written and verbal.

Knowledge on Software Development and Software Testing life cycles.Knowledge in testing applications and manual testing techniques. Ability to work as a team member to perform Functional, GUI and Database testing. Training in advanced visualization, mobility, quality assurance, along with other aspects of Information Technology.

Responsible for participating in the departments regulatory activities related to the DOI (GA Dept of Insurance), CMS (Center of Medicare and Medicaid Services) and OPM (Office of Personnel Management) regulatory agencies for Kaiser product and service offerings. Partner with Quality Assurance Analyst, department analysts, vendors & KPIT to deploy benefits configuration changes and benefits systems changes, including but not limited to benefits systems solution design, testing releases and upgrades. Participated in the content development and introductory management of EOC documents, group agreements and proposal templates. Maintained, updated and recommended changes to the Benefit Summary software system and Benefit build. Collaborated with Sales and Marketing, Proposal Development, Product Development, Benefit Implementation, Compliance, Customer Services and other internal and external teams and customers. Actively participated in the annual open enrollment activities related to regulatory requirements including DOI filings, CMS PBP software uploads, and FEHB brochure development. Exposure to ID card EOC production and distribution.

Provided administrative support to the Director of Clinical Education and assisted other department leaders with administrative duties. Preparation of business correspondence, employee orientation manuals, and quarterly reports. Responsibilities included scheduling patient for rehabilitation appointments. Maintained medical records and clinical manager schedules for branch offices. Distributed and tracked company assets intended for nursing staff communication.

Decatur, Ga

Duties included filing insurance claims for a seven doctor Internal Medicine practice. Reviewed insurance explanation of benefits daily to verify accuracy of payment from health insurance carrier. Posted payments daily to patient accounts to update account receivables. Prepared and answered correspondence to and from insurance carriers concerning insurance submissions.