Jacqueline Reynolds-Douglas

• Oversaw regional provider enrollment and eligibility inquiries for TRICARE providers, civilian healthcare systems, MTFs, and DHA, ensuring accurate and timely responses.
• Investigated and resolved complex credentialing disputes involving enrollment, eligibility, billing, referral, and network participation under TRICARE and DHA requirements.
• Conducted briefings and seminars on TRICARE enrollment, participation, and network requirements, enhancing compliance understanding among civilian and military healthcare partners.
• Maintained credentialing documentation, provider records, and issue resolution tracking in compliance with TRICARE and DHA federal standards, supporting audit readiness and network integrity.
• Facilitated provider escalations across MTFs, DHA, and civilian stakeholders, effectively resolving enrollment, eligibility, referral, and access-to-care issues to uphold TRICARE network continuity.
• Strengthened provider relations by maintaining accurate records and documentation for 100% of assigned cases, supporting regulatory compliance, audit readiness, and consistent communication across government and civilian healthcare partners.

• Maintained patient profiles and operational documentation for 60-80 field technicians using Salesforce and MapAnything, ensuring data accuracy across scheduling and healthcare workflows.
• Coordinated patient scheduling and documentation across multiple healthcare plans and campaign regions, meeting contractual performance requirements and maintaining accurate records.
• Resolved patient complaints, documentation discrepancies, and operational issues across assigned healthcare plans, maintaining timely communication and accurate records.
• Trained internal staff on documentation, scheduling, and operational workflows, and analyzed performance data to drive continuous process improvement and stronger network coordination.
• Remote/Hybrid

● Assisted physicians with patient procedures including EKGs, phlebotomy, glucose testing, and pulmonary function tests across a high-volume clinical setting.
● Conducted thorough patient interviews to collect health history, vital signs, and information on current medical issues; communicated patient status accurately to care teams to ensure continuity of care.
● Completed prior authorizations for medications, procedures, and diagnostic testing across multiple insurance companies.
● Coordinated controlled substance safety checks with the Chief Medical Officer; quality-reviewed all controlled medications prescribed clinic-wide on daily, weekly, and monthly cycles.
● Fitted patients with continuous glucose monitoring devices, adjusted insulin pumps, and provided diabetic education on insulin and oral medication regimens.
● Contacted patients directly with lab and medical testing results, ensuring clear and empathetic communication of sensitive health information.

• Served as Preceptor and Super User for the Memphis market across 3 clinics, training clinical staff on EHR workflows, documentation standards, and regulatory requirements.
• Led clinical and front-office operations in a high-volume managed care environment, supporting provider scheduling, patient intake, clinical documentation, laboratory workflows, and blood-draw procedures.
• Processed prior authorizations for medications, procedures, and diagnostic services across multiple commercial payers, building expertise in payer requirements, approval workflows, and insurance compliance.

● Dispatched calls to police, fire, and medical response personnel, accurately assessing each situation to prioritize and coordinate the appropriate response.
● Gathered caller information, reviewed associated computer data, and documented critical details in real time within call tracking and assignment systems.
● Assigned alarm codes to all AutoZone store locations nationwide; supported store entry and closure procedures remotely via phone.
● Managed alarm permit acquisition from local and county officials for store locations and maintained detailed permit and fine records related to excessive alarm incidents.
● Communicated directly with local law enforcement regarding outstanding alarm fines and invoice management across store locations.
● Utilized radio, telephone, and computer dispatch systems to relay updated information to first responders in real time.

● Managed high-volume emergency inbound calls with composure and professionalism, gathering pertinent information quickly and efficiently under pressure.
● Dispatched police, fire, and EMS personnel to emergency and non-emergency incidents, prioritizing responses and tracking units in real time across radio, telephone, and CAD systems.
● Documented caller information and critical incident details accurately in call tracking and assignment systems, maintaining complete and reliable records.
● Provided ongoing status updates to first responders via radio and computer systems as new information developed.
● Assisted departments with special requests including BOLOs, and communicated delays, accidents, and road/transportation incidents as they occurred.
● Demonstrated consistent emotional intelligence and de-escalation skill when handling callers in crisis situations across a five-year tenure.