Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:

Enthusiastic individual with superior skills in working in both team-based and independent capacities. Bringing strong work ethic and excellent organizational skills to any setting. Excited to begin new challenges with successful teams.

  • Administrative support
  • Problem resolution
  • Planning and Coordination
  • Accounts Receivable
  • Customer service and support
  • Policy analysis
  • Benefit explanation
  • Documentation review
  • Accident investigations
AMSA-Float, Monday - Friday 40 Wk, 07/2020 to Current
Veterans AffairsCity, STATE,

•Collaborate and communicate with a wide range of medical clinicians across multiple disciplines to ensure medical care to patients is met

•Consult, monitor, scheduled and rescheduled patients for 3 clinics

•Communicate tactfully and effectively via electronically, by phone, in person, and by writing with internal and external customers

•Knowledgeable of the technical health care processes including but not limited to scheduling a across interdisciplinary coordinated care delivery as it relates to patients care

•Advance Knowledge of medical terminology due to the technical nature of language utilized by clinicians

•Identified operational improvements to drive efficiency and quality of care

•Answered appointment calls to streamline office operations.

Worker Comp Administrator Monday - Friday 40 HR/WK, 10/2019 to 03/2020
Swissport USA Inc.City, STATE,

● Single-handily works and maintains the company's Worker Compensation program while managing the OSHA Log for the Boston station resulting in meeting annual deadlines

● Works closely with the Safety & Quality Manager to ensure that the Claim Reduction Program and Standard Operating Procedures are being followed & contribute to procedural and operational audits

● Monitor days out of work log & follow up with what can be done to get the injured employees back to work as soon as possible

● Monitor claims cost & update spreadsheet with Reserve increase/decrease

● Participate in the Monthly Safety Committee Meeting and posted safety and near misses bulletins

● Work closely with company's Adjuster to put procedures in place to help cost control and refined turn around time on receiving all other related injury documentation resulting in effective communication

● Provided effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process

● The point of contact for 4 business lines for all documentation regarding incident, includes internal safety notify and investigation details, as well as any health information relevant to the claim

Patient Account Rep Monday - Friday 40 HR/WEEK , 08/2018 to 10/2019
Brigham And Women's Physician OrganizationCity, STATE,

● Responsible for daily management of account receivable process and follow up in the billing system, including daily screening and correction of claims for accuracy for the surgical department
● Reviewed, corrected and completed edit queues weekly for the particular insurances assigned for the surgical department
● Follow-up on pending claims, includes following up with the insurance company, document the findings and gather/send the necessary documentation to process the claims
● Responsible for the appeals process, which included researching payer websites, pulling of documentation such as EOB's, requesting medical records, and reviewing registration, eligibility and benefits, as well as documenting all work performed on the patient invoice.
● Handled customer service calls and demonstrated excellent customer service skills, resulting in 95% patient understanding
● Handled confidential information with accordance with HIPAA standards
● Conducted research on forensic account balances that have been open for over a year or more by reviewing invoices history to determine payments/retractions and inform management of discoveries for swift resolution
● Provide Management with analytical data and trend analysis that occur within insurance carriers

Referral Coordinator Monday - Friday 40 HR/Week, 08/2016 to 02/2018
Molina Medical GroupCity, STATE,

● Processed medical referrals for 5 providers in a timely manner to include, but not limited to, completion of service request (direct and prior authorization referrals) forms manually and/or through EMR & request for medical documentation upon completion of the referral

● Faxed service requests to Utilization Management department for approvals

● Processed and send requests to the specialty offices for processing and scheduling of patient appointment

● Notified patients of scheduled appointments by phone, in person with appointment information or by mail and documented in the patients chart

● Obtained insurance information from patients, which included collecting co-payments and self-paid balances

● Processed consult reports that were received, completed and closed referrals in the patient's charts

● Reported referral problems to providers, supervisor and administrator

● Reviewed referral log daily and provided weekly progress reports to supervisor and administrator

● Worked closely with outside vendors such as Utilization Management, Provider Services and Contracting Department to establish and build effective working relations

● Single-handily managed, worked, maintained, and closed a backlog of two years of clinic referrals, denials and authorizations within the first year of employment

Education and Training
Certificate: Six Sigma Black Belt Online Course, Expected in 2018
The University of New Mexico - Albuquerque, NM
MBA: Business Administration And Management, Expected in 11/2013
American InterContinental University - Online - Schaumburg, IL

● Specialization in Management

Bachelor of Science: Criminal Justice, Expected in 09/2011
American InterContinental University - Online - Schaumburg, IL

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School Attended

  • The University of New Mexico
  • American InterContinental University - Online
  • American InterContinental University - Online

Job Titles Held:

  • AMSA-Float, Monday - Friday 40 Wk
  • Worker Comp Administrator Monday - Friday 40 HR/WK
  • Patient Account Rep Monday - Friday 40 HR/WEEK
  • Referral Coordinator Monday - Friday 40 HR/Week


  • Certificate
  • MBA
  • Bachelor of Science

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