Remote Data Entry Specialist with Admin Leadership Experience
Resume:
Michelle D. Jordan
https://www.linkedin.com/in/michelle-jordan ************@*****.***
Lifelong Learner who proactively drives process improvement through positive collaboration and forward thinking
Proven Healthcare professional with diverse experience including leadership, process improvement, data analysis, project management, people development, research, training, consumer communication, and thought leadership. Able to maintain a sense of humor under pressure. Talent for quickly mastering new technology and processes. Demonstrated history of producing accurate and timely reports and meeting stringent Centers for Medicare and Medicaid (CMS), Social Security Administration (SSA), and insurance guidelines as well as internal Service Level Agreements (SLAs). Effective negotiator with ability to adapt communication style to enhance situational outcomes. Comfortable providing constructive critiques to peers and direct reports.
Data Analysis Process Improvement People Development Leadership Research Training Consumer Communication Medicare Customer Service Marketing Inventory Management
Professional Experience
Humana Insurance Company, Louisville, KY 2010 to 2025
Medicare Billing Supervisor 2014-2025
Work within thorough, prescribed guidelines and procedures; use independent judgment requiring analysis of variable factors to solve basic problems; collaborate with management and top professionals/specialists in selection of methods, techniques, and analytical approach. Maintain related documents, updates corresponding records, and responsible for enrollment and billing query. May be responsible for or assist in addressing broad, complex enrollment and billing issues. Decisions related to schedule, plans, and daily operations. Performs escalated or more complex work of a similar nature and supervises a group of associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies. Coach associates to improve; drive development of their skill sets; implement processes to maintain compliance
Created 4 new Quality Audit templates for SSA team to be used by Operational Excellence team for departmental Quality scoring
Streamlined 3 Process documents in Mentor to facilitate understanding and improve member and associate experience
Mission Possible second runner up for suggested Part B improvements for Customer Service, Marketing, Direct Market Sales, and back office outbound calls to members
Recruited for and worked on a CTM Reduction Task Force in 2018 and developed an SSA brochure to be mailed to new members.
Received STAR Award 11/2020 for being an outstanding leader.
Medicare Billing LEP Production Lead 2012-2014
Responsible for the accurate enrollment and billing process for Medicare members. Lead advanced and highly specialized administrative, operational, and customer support duties that require independent initiative and judgment. Maintained related documents, updated corresponding records, and responsible for enrollment and billing reconciliation. Coordinated work activities and monitored progress towards schedules and goals and often oversaw work of others and was the primary administrative owner of Late Enrolment Penalty (LEP) processes. Worked within broad guidelines with little oversight.
Managed multiple teams for bailout and maintained Compliance spreadsheets and deadlines for specialized LEP work.
Received STAR Award 12/2013 for being a go to person on the floor and helping other teams with LEP issues.
Medicare Billing Specialist- Billing SME 2010-2012
Duties included utilizing multiple systems and programs simultaneously to complete the necessary research to determine correct action to allow correct reconciliation of member accounts; met and maintained production goals while maintaining quality metrics; utilized research, problem solving, and analytical thinking skills to resolve and determine corrective actions for member refunds and account reconciliation. Adapted quickly to new processes and changes. Trained peers on new processes and cross functional work.
Selected to transition to a new team (Late Enrollment Penalty Team) to gain more billing knowledge and to expand my horizons for exceptional work
Recognized for outstanding contributions to Humana’s success with a Star Award presented for going above and beyond and learning new processes (SSA as well as others) and sharing the knowledge with my team via presentations and documents.
Selected to perform CTM Bailout Project involving extensive research to find the root cause of Complaint Tracking Modules (CTMs)
Maintained quality score of 98% while averaging over 100% daily production
Received STAR Award 3/2011 for learning a new job function and rolling it out to my team.
Medicare Billing SME certified
Selected to work several CMS Audits due to detailed nature.
Prior Experience
GameStop, Assistant Manager
Duties included selling video games; assisting customers to find appropriate games; marketing; merchandising; customer service; managing employees; inventory management; daily logistical operations of store, new hire training, and preparing and filing administrative reports.
LDI Reproprinting, Customer Service
Duties included daily logistical operations of business including: fielding telephone inquiries; taking and completing blueprint orders; receiving account payments and fielding various accounting inquiries; rotating paper stock; troubleshooting printer errors and software errors; cash handling; new hire training; and general office duties.
AMC Theatres, Operations Coordinator (Assistant Manager) & Film Crew Trainer
Duties included managing 50+ employees; daily logistical operations of theatre including facilities, food and beverage, box office, film booth, and cash handling; preparing and filing administrative reports; ; inventory management; disciplinary referrals and documentation and various HR duties; movie marketing; new hire training; developing, employing, and carrying out contests to meet financial goals; and general office duties
Education
Bachelor of Arts (BA), Psychology, Agnes Scott College, Decatur, GA
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