Operations Support Specialist

CRYSTAL KIMPSON

*********@*****.*** • 803-***-**** • linkedin.com/in/crystal-kimpson-49620b230/

OPERATIONS SUPPORT SPECIALIST

SUMMARY

Detailed-oriented and results-driven administrative specialist with extensive experience in healthcare operations, clerical support, and client-facing services. Adept at streamlining workflows, managing sensitive medical information, and ensuring regulatory compliance in high-volume environments. Recognized for enhancing team collaboration, efficiently resolving client inquiries, and consistently achieving organizational KPIs. Proven ability to thrive in fast-paced environments with a commitment to operational excellence and client satisfaction. Dedicated to leveraging skills in data management to drive continued success in office environments.

EXPERIENCE

Virta Health, Member Administrative Specialist

Oct 2024 - Jul 2025

Supported day-to-day administrative operations for Virta’s member advocacy team, ensuring high-quality service delivery for patients enrolled in programs for diabetes, type 2 diabetes, and sustainable weight loss programs.

Facilitated applicant and member communications via ticketing system in an empathetic, pleasant, and professional manner, while maintaining HIPAA compliance.

Collect clinical information for final medical approval, such as lab values and product diagnosis codes.

Served as subject matter expert to ensure seamless patient onboarding by escalating billing inquiries, transcribing lab orders, updating member medications, and performing eligibility checks.

Collaborated cross-functionally with clinical operations, coaching, and product teams to escalate complex member cases or improve internal workflows.

Coordinated logistics for lab kits, prescriptions, and medical supplies, troubleshooting delays or shipment issues when applicable.

Crossed-trained in several departments, leading to measurable enhancements in workflow efficiency.

Executed manual insurance checks using existing processes and tools to resolve escalations and verify member eligibility for treatment.

Retained knowledge of various health plans, including Medicaid, Medicare, PBMs, and private insurances to determine accurate eligibility decision-making.

Maintained team SLAs and KPIs to support internal stakeholders, including transcriptions per hour, email solves per hour, speed to resolution for eligibility escalations, and passing Quality Assurance.

Leveraged SQL to query internal databases and extract member or operational data, enabling faster resolution of complex cases and identification of workflow gaps.

Co-founded team engagement committee to foster morale.

Cognizant Technology, Senior Process Executive

Jul 2023 - Jul 2024

Optimized AI-driven patient encounter processing in healthcare, enhancing efficiency for clinicians across multiple specialties nationwide.

Documented, edited, and proofread clinical encounters (HPI, ROS, Physical exam, Results, Assessment, Plan) across diverse medical practices, ensuring accuracy and timely turnaround.

Pioneered advanced research techniques to verify intricate medical data, enhancing the reliability of patient records and clinical information.

Consistently surpassed performance metrics, maintaining a 98%+ accuracy rate in complex medical documentation and research.

Maintained HIPAA compliance and PHI Safeguarding regulations.

Daily use of various electronic medical records.

Fostered seamless communication between AI systems and healthcare professionals, streamlining patient data management processes.

Nuance Communications Inc., Quality Documentation Specialist

Jun 2021 - Jul 2023

Attributed to AI training initiative, boosting QDS productivity by 69% while maintaining 98%+ accuracy in SOAP note documentation for ENT, Family Medicine, Internal Medicine, OB/GYN, Orthopedics, Podiatry, Urology, and Urgent Care. From start to finish, owned and created real-time SOAP note documentation utilizing several electronic medical records (HPI, ROS, Physical Exam, Results, Assessment, Plan), significantly reducing provider charting time and improving patient visits.

Adapted quickly to frequent changes in provider templates, documentation standards, and platform updates.

Collaborated with clinical documentation specialists and medical scribes to address discrepancies and ensure documentation reflected provider intent and met legal and regulatory requirements.

Analyzed and optimized documentation processes, contributing to substantial improvements in team productivity and accuracy.

Daily collaboration with team and cross-functional departments to achieve foremost efficiency and productivity.

Ensured compliance with HIPAA and other patient privacy regulations in all documentation handling and system usage. Familiarity with medical terminology and ICD-10 codes.

SCDDHS, Human Services Specialist II - MAGI

Jun 2019 - May 2021

Determined Medicaid insurance eligibility for individuals and families following policies and procedures, ensuring compliance with federal and state regulations.

Processed new applications, renewals, and case changes in state eligibility systems, ensuring timely and accurate benefit determinations.

Conducted interviews with clients in person, by phone, or virtually to collect required information and explained available health coverage options.

Configured complex calculations arbitrating retroactive coverage and household income, ensuring precise benefit determinations. Interacted and provided clear communication with applicants, members, staff, general counsel (appeals), and 3rd parties to ensure accurate eligibility determinations.

Served as subject matter expert regarding all eligibility practices, offered services, and available community resources.

Maintained detailed case records and documentation in state systems, ensuring data integrity, timeliness, and strict adherence to HIPAA and confidentiality standards.

Resolved annual backlog during pandemic, ensuring continued benefits for families amid government shutdown and contributing to office analytics.

Enhanced productivity by efficiently navigating software systems, managing cases in a queue workflow. Maintained quarterly metrics regarding accuracy and production.

Wise Staffing Group, Office Assistant/Recruiter

Nov 2017 - Feb 2019

Streamlined HR processes, while enhancing efficiency in candidate screening, onboarding, and compliance management, resulting in swift placement rates.

First person of contact for all inquiries, questions, and concerns.

Fostered strong relationships with clients and candidates, facilitating smooth communication and efficient problem-solving throughout the staffing process.

Managed 3-line telephone system, email, and voicemail messages.

Developed and executed new outreach methods, significantly expanding the candidate pool and increasing successful placements across industries.

Administered HR documentation, ensuring accuracy in I-9 verifications, background screenings, W-4 forms, and benefit enrollments for regulatory compliance.

Fostered strong relationships with clients and candidates, facilitating smooth communication and efficient problem-solving throughout the staffing process.

Palmetto Development Group, Executive Administrative Assistant

Apr 2014 - Feb 2017

Enhanced CEO productivity by optimizing administrative workflows, ensuring timely decision-making and strategic execution. Cultivated strong relationships with key stakeholders, including council members and board members, to advance organizational goals.

Executed workshops that educated the public, successfully attracting new businesses and fostering community engagement. Managed office operations, calendars, and scheduled meetings, ensuring seamless leadership continuity and operational efficiency.

Crafted precise meeting minutes, memos, and correspondence, maintaining clear communication channels across the organization.

Planned and reserved travel arrangements.

Hope Health, Medical Case Manager

Nov 2013 - Mar 2014

Administered comprehensive assessments to identify medical, psychological, and social service needs of individuals living with HIV/ AIDS.

Developed and implemented individualized care plans in collaboration with patients, providers, and multidisciplinary teams to support treatment adherence and overall well-being

Coordinated access to HIV-related medical care, mental health services, substance use treatment, housing, transportation, and other essential resources.

Monitored patient progress and adherence to antiretroviral therapy (ART), ensuring timely follow-ups, lab testing, and medical appointments.

Provided education and counseling on HIV transmission, medication adherence, risk reduction, and health maintenance. Served as a liaison between patients and healthcare providers, ensuring clear communication and continuity of care.

Advocated for client needs while navigating complex healthcare and social service systems, including Medicaid, Ryan White services, and other community-based programs.

Conducted ongoing risk assessments and reassessments to adjust care plans based on evolving patient needs and goals. Maintain accurate, confidential documentation in compliance with HIPAA, Ryan White reporting requirements, and agency standards.

Participated in conferences, team meetings, and staff trainings to ensure integrated service delivery and up-to-date knowledge of HIV care and policy changes.

Calhoun Convalescent Center, Certified Nursing Assistant Jan 2010 - Sep 2010

Provide direct patient care, including assistance with activities of daily living (ADLs) such as bathing, grooming, feeding, toileting, and mobility.

Monitor and record vital signs (blood pressure, temperature, pulse, respiration) and report any changes to nursing staff.

Support nursing staff with patient assessments and ensure timely communication of patient needs or concerns.

Assist with admission, transfer, and discharge procedures, including gathering personal belongings, reinforcing discharge instructions, and ensuring patient comfort and safety.

Participate in discharge planning by communicating patient readiness and barriers to discharge to the interdisciplinary team.

Maintain accurate patient records and documentation in compliance with facility protocols and HIPAA regulations.

Ensure a clean, safe, and supportive environment by following infection control procedures and assisting with room maintenance.

Provide emotional support to patients and families, promoting dignity, comfort, and respect.

Collaborate with healthcare teams to ensure coordinated care and high-quality service delivery.

EDUCATION

Claflin University

Bachelor • Applied Science in Organizational Management • 2018

Denmark Technical College

Associate • Applied Science in Administrative Office Technology • 2013

Orangeburg-Calhoun Technical College Certificate • Nursing Assistant (CNA) • 2010

SKILLS

Ambiguity Critical Thinking • Case Management • Conflict Resolution • Data Entry • Effective Written and Verbal Communication • Grammar Proficiency • HIPAA and PHI Safeguarding • Member Advocacy • Multi-Channel Communication • Organizational Management

TECHNOLOGY

Applicant Tracking System • Change Healthcare • CRM • Dax Studio • EHR/EMR • Google Suite • Health Gorilla • Hyland OnBase • iOS Operating Systems • Microsoft Office Applications • Zendesk • Salesforce • SQL • Slack

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