Seeking Remote/Work From Home Employment

JESSICA JOHNSON

*** *********** *** *******, ** *904 · 769-***-****

*****************@*****.***

Professional innovative and transformative remote Credentialing, Benefits, Claims, Grievance, Appeal, Customers Service Analyst with over 8 + years of experience within the Healthcare Industry. Adept at handling 50+ calls while working in fast-paced environment, detail oriented in completing projects. spearheaded, trustworthy, ethical, proven ability to revitaize discreet, committed to superior customer services. Empowered and committed to team improvement and impacting team success.

EXPERIENCE

AUGUST 2021—FEBRUARY 2022

APPEALS & GRIEVANCE SPECIALIST, la care

contractor the JACOBSON group

Transmitting appeals of clinical denials to the appropriate professional for review and tracking review completion to ensure final closure of the associated case. Maintaining documentation associated with complaints, appeals and grievances to ensure responses are timely and in compliance with all applicable regulations and contracted timeframes

Achieving a high level of workload volume, ensuring accuracy and compliance with scheduled deadlines.

MAY 2020 – JUNE 2021

CUSTOMER SERVICE REPRESENTATIVE II, centene magnolia health

contractor healthcare support

Identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment. Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment. Handle all registration and activation duties with credentialing providers. Providing benefits to provider and members.

MARCH 2018 – APRIL 2020

MEDICAL SCHEDULER, MEDICAL PRACTICE SOLUTION

Maintain physician’s schedules scheduling office visits, procedures and recall scheduling. Assist in patient registration, triage call messages for medical staff patient registration and financial transactions.

JANUARY 2015 – DECEMBER 2017

CUSTOMER SERVICE REPRESENTATIVE, conduent

Consult with customers by telephone respond promptly to customer inquiries handle and resolve customer complaints perform customer verifications process orders, forms, applications and requests organize workflow to meet customer timeframes direct requests and unresolved issues to the designated resource manage customers’ accounts keep records of customer interactions and transactions record details of inquiries, comments and complaints record details of actions taken communicate and coordinate with internal departments follow up on customer interactions provide benefit and claim information, make payments, set up payment arrangements, update demographic information, change primary care physicians, locate doctors and equipment suppliers and follow up with members.

EDUCATION

JUNE 2018

BACHELOR’S IN BUSINESS ADMINSTRATION, strayer

AUGUST 2008

CERTIFIED MEDICAL ASSISTANT, VIRGINIA COLLEGE

SKILLS

Proficient with Claim Processing Software

Medical terminology knowledge

Clerical

Billing

Administrative Support

Faxing, Printing, Filing

Excel, PowerPoint, Microsoft Words, Microsoft Outlook

Inbound and Outbound Calling

Excellent Phone Etiquette

Actively Listen

Empathy

Problem Solving

Decision Making

Policy Knowledge

Dependable

Attentiveness

Communication

Leadership

Time Management

Interpersonal Skills

Adaptability

Organizational Skills

Multitasking

Reference upon Request

Contact this candidate