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Highly organized, strong written and oral communication skills, employee relations, review of employee application, people-oriented, able to prioritize tasks and multi-tasks, conduct telephonic interviews, knowledge of contracts, goal-oriented, result-oriented, customer focus, excellent leadership and managerial skills, able to solve problems independently, administer employee benefits, able to type, educate employees, knowledge of multiple computer systems and programs, team player, risk management, benefits management, human relations, verification of eligibility, strong analytical skills and problem solving, internet research and data entry skills, excellent interpersonal skills, conflict resolution skills, financial benefits computations, highly motivated, review of documents, pay attention to detail, proficient with microsoft office edge or related software, benefits Interpretation, special projects, able to perform efficiently and effectively, able to meet time sensitive deadlines.
Microsoft Office, Outlook, Publisher, Internet explorer, Munis, Global, QNXT, IONYX, TeleNurse, Visiflow, MediFax, Citrix, Lotus Notes, People Soft, Cerner, Emdeon Office, Invision, Power Chart, Pace, UltiPro, Kronos, Workability, Pega Reach Professional, Cisco, THAA, Workday, Skype, Teams, Edge, WebEx |
Alorica Inc. – Saraland, AL,
- Knowledge of short-term and long-term disability, leave of absence, FMLA, worker's compensation, and leave management
- Checked accuracy and completeness of benefits applications and documents
- Provide assistance to plan participants by educating/explaining benefits information and plan contract
- Communicated effectively via email, phone, and letter
- Conduct telephonic interview
- Review contracts and coverage information
- Administer and manage benefits
- Review payroll documents and eligibility verification
- Review and document correspondence
- Abide by Federal and States regulations
- Used plan formula calculation and math skills to calculate deductions and disability benefits
- Manage assigned daily tasks and meet monthly deadlines
- Generate weekly reports and lead team meetings
- Train and assist employees with process
- Build and maintain strong partnerships with external departments
Christus Health – Palestine, TX,
- Interview patients in a hospital setting and/or home visits to assist them in obtaining maximum benefit coverage
- Complete applications for state DCF and Social Security Administration Disability federal/state programs
- Work very closely with case management and other hospital personnel to obtain information and resources required for the application process
- Conduct mental and physical assessment for application process
- Maintain an ongoing line of communication with patients regarding status of their claims and pending application.
- Maintained customer accounts and information in electronic reporting system.
- Maintained knowledge of community services and resources and referred patients to appropriate organizations.
Molina Healthcare Of Florida – City, STATE,
- Answer all incoming calls from members and providers regarding eligibility, benefits, claims, medications, services and satisfactorily resolve all issues within expected response time
- Educate members on the eligibility process
- Maintain above departmental goal quality customer service to meet Florida Medicaid service level requirements
- Research problems, handles complex issues and complaints to provide the best solutions available within Medicaid policies and contract guidelines
- Educate members on HEDIS process and requirements mandated by State of Florida
- Work in a cooperative manner with other departments to provide excellent services to members and providers
- Complies with Florida Medicaid guidelines to ensure that members are receiving the best quality medical care and services
CHCS Services – City, STATE,
- Transcribed Long term care assessments and maintained above the requirement of 98% accuracy rating
- Provided administrative assistance to the Vice President
- Generated end-of-the month clients’ status reports
- Assisted the RN Case managers with the process of the Long-term care assessments
- Prepared power point presentation for meetings
- Coordinated departmental social events
- Trained staff, distributed their assignments, and managed workload within the department
- Verified licensing credentials for Home Health Agencies and Long-Term Care providers
- Worked closely with Home Health Agencies to set up care for clients
- Communicated the assessment process with the field RN Case managers and clients
- Provided high quality customer service to clients and providers
- Received “Employee of the Month” award twice for high quality performance.
Florida International University - Miami, FL
Florida International University - Miami, FL
Florida International University - Miami, FL
Florida International University - Miami, FL
- https://www.linkedin.com/in/Jessica-Claire-b1897b68/
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School Attended
- Florida International University
- Florida International University
- Florida International University
- Florida International University
Job Titles Held:
- Benefits Analyst Manager
- Healthcare Representative
- Member Services Representative
- Administrative Support Staff/Med Tech
Degrees
- Master’s
- Certificate in Human Resources and Management
- Certificate in Policy Management
- Bachelor
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