Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:

Accomplished, Hard-working health care professional with 15+ years of experience with The Johns Hopkins Health System and proven knowledge of case management, data collection, analysis, medical billing, and third-party payer issues. Experience with population health care coordination, including post-surgery, physical therapy, oncology, maternity, behavior health, with various patients, including adults, pediatrics, Med Advantage, and special needs patients. Excellent analytical, multitasking, organizational, and time management skills. I aim to leverage my skills to obtain employment with an exceptional health care organization that will allow me to display my extensive health care background while continuing to grow and develop professionally and personally.

  • EPIC Super User, MSR, AERIAL, SharePoint,
  • AHIMA- Registered Health Information
  • Excel, JCARE, EPR. IDX, MC400, Technician (RHIT) Coding Certification
  • Inpatient & Outpatient Coding
  • EMR / EHR
  • Release of Medical Records
  • Medical Records Management
  • Analytical/Problem-Solving, Multitasking, and
  • Regulatory Compliance time management skills
  • Medical office administration
  • Critical Thinking
  • Epic Systems
  • Verbal and Written Communication
  • Decision Making
  • Time Management
Care Management Coordinator, 12/2013 to Current
Adventist Health NwKansas City, MO,
  • Analyzed new referrals to determine member eligibility for case management based on claims data, diagnosis, and medical conditions and refer to appropriate case management program (context/number show many/often) phone/electronic referrals
  • Collaborated the cases to the team of nurses to maintain an active case management load of 65+ cases from a variety of lines of business, such as Priority Partners, Johns Hopkins Advantage MD, EHP, and
  • Johns Hopkins US Family
  • Assist case managers with coordinating patient care (mailing educational literature, Welcome packets,
  • Advance directives, Consent forms, etc.)
  • Verify member eligibility for all lines of business including EHP, Tricare, Johns Hopkins Advantage
  • MD, and Priority Partners
  • Worked as an Epic superuser, and proficient using Maryland Medicaid Eligibility Verification System (EVS)
  • Conduct Patient Activation Measures (PAM surveys) and SF-12 Surveys telephonically and scored surveys using Flourish and AM-I-Healthy database
  • Determine Proper ICD-9 and CPT coding for authorizations
  • Coordinate patient care and provide case management services to (Adults, Pediatric, Maternity,
  • Behavior health and the Elderly population)
  • Coordinate various member service including requests for durable medical equipment, home health services, and specialty visits
  • Compose and generate patient, case managers, and physician mailings
  • Collect data, review and work daily reports
  • Train and orient new employees.
Medical Records Specialist, 02/2021 to 05/2022
Iron MountainMontpelier, VT,
  • Maintains medical records in accordance with the SNF (Skilled Nursing Facility)
  • Assures maintenance of active and discharge medical records
  • Increased the safeguards medical information against loss, destruction, or un-authorized use
  • Maintains system for retrieval of discharge medical records. Maintains thinned files in proper order to assure ease in retrieval and integrity of the resident s medical record
  • Responds to all requests for medical records copies from attorneys, medical facilities, etc., and provide copies in accordance with HIPPA regulations and state and federal laws
  • Maintain log of requests
  • Obtains necessary information on residents as needed and other requests for residents and/or health care decision makers
  • Monitors the discharged clinical record closed chart process, maintains the Discharge Chart Control
  • Log, and maintains the log of records stored off-site (Medical Records Discharge File Log)
  • Provided respectful assistance to patients, staff members and insurance company representatives.
  • Pulled patient records and transferred information to appropriate parties.
  • Maintained electronic medical records for all clients
  • Verified record copies before handing each over to check for and remove unnecessary details.
  • Entered patient insurance, demographic and health information into software and confirmed records.
  • Set up patient charts and documented information in various company software.
  • Streamlined day-to-day office processes to meet long-term goals.
  • Determined and implemented techniques to improve medical records retrieval process.
  • Scanned incoming documentation.
  • Maintained complete confidentiality in accordance with organization and legal requirements.
Case Management Clerk, 07/2011 to 12/2013
Johns Hopkins Healthcare, LLCCity, STATE,
  • Advised & support various disease case management program providing assistance for various complex medical request
  • Provided administrative support to the Case Management Assistants
  • Coordinated patient referrals for the Partners with Mom program
  • Reviewed Maryland Prenatal Risk Assessments (MPRAs) to determine member eligibility for case management, and enter into the maternity database
  • Collected data and issue monthly reports to the Department of Health and Mental Hygiene and Local
  • Health Department for analysis
  • Review and managed incoming Health Risk Assessments (HRAs) for completeness and accuracy
  • Maintained and entered complex data in the disease management databases
  • Generated member and physicians' mailing, fax, scan, and obtain incoming correspondence
  • Distributed health education information to members using disease-specific literature
  • Verified member eligibility for all lines of business
  • Maintained inventory of educational material and supplies
  • Participated in various departmental special projects in support of the care management department
  • Streamline & used multiple internal and external systems including IDX, EPR MSR MC400,
  • SharePoint, and multiple disease management database.
  • Participated in case conferences with multi-disciplinary team to discuss client care planning and progression.
  • Facilitated ongoing case management services to support successful outcomes and meet stabilization goals.
  • Cooperated with local service providers, outreach workers, case managers and collaborative agencies to facilitate services for members.
  • Protected patient data in alignment with HIPAA privacy protocols.
Operating Room Associate, 12/2001 to 07/2011
Johns Hopkins HospitalCity, ,
  • Coordinated patient registration in the Obstetrical and Gynecology unit
  • Arranged patient charts and assisted in a wide range of clerical duties
  • Performed the ordering the material and environmental supplies to support the OB/GYN unit
  • Transported patients and equipment
  • Delivered records and specimens as requested
  • Cleaned and stocked operating rooms, labor and delivery rooms, antepartum, postpartum rooms according to standards and procedures
  • Initiated a positive work environment as an active team member.
Education and Training
Bachelor of Science (B.S: Health Service Management, Expected in 12/2022
University of Maryland-University College - Largo, MD
Associate of Science: Health Informatics and Technology, Expected in 01/2018
Community College of Baltimore County - Baltimore, MD
Associate of Arts: General Studies, Expected in 01/2013
Community College of Baltimore County - Baltimore, MD

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Resume Overview

School Attended

  • University of Maryland-University College
  • Community College of Baltimore County
  • Community College of Baltimore County

Job Titles Held:

  • Care Management Coordinator
  • Medical Records Specialist
  • Case Management Clerk
  • Operating Room Associate


  • Bachelor of Science (B.S
  • Associate of Science
  • Associate of Arts

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