Jade Watts
Lodi,CA
Summary
Strategic and detail-oriented healthcare operations professional with over 12 years of progressive experience, including underwriting, billing, eligibility, and administrative support. Known for quickly mastering new systems, streamlining workflows, and delivering clear, polished communication across teams. Adept at navigating complex challenges with integrity and empathy and committed to work that aligns with organizational values and fosters meaningful impact.
Overview
18
18
years of professional experience
Work History
Billing Representative
Wollborg Michelson for Blue Shield of California
10.2021 - 11.2021
- Reconciled and maintained group account files to ensure accuracy and compliance across internal systems
- Investigated and resolved eligibility discrepancies, improving data integrity and member experience
- Monitored delinquent processing to proactively address issues and support timely resolution
- Generated detailed reports and conducted targeted research projects to inform operational decisions and drive process improvements
Administrative Assistant III
Health Plan of San Joaquin
11.2015 - 09.2016
- Drafted and prepared complex correspondence, reports, and documentation for internal and external stakeholders
- Coordinated logistics and materials for high-level committee meetings, ensuring seamless execution
- Managed incoming communications by screening and routing calls with professionalism and discretion
- Handled daily mail operations, including opening, sorting, and distribution
- Scheduled and maintained departmental calendars for the Quality Director and Medical Director, optimizing time management
- Procured and maintained office supplies to support departmental efficiency
- Assembled, formatted, and distributed sensitive materials to appropriate recipients while maintaining confidentiality
- Supported departmental reporting by compiling, entering, and maintaining accurate data
- Created and maintained performance reports for HEDIS measures to support quality improvement initiatives
- Facilitated virtual meetings via GoToMeeting, ensuring technical readiness and participant engagement
Superuser Group Processor
Randstad Professionals for Blue Shield of California
05.2015 - 09.2015
- Conducted detailed analysis of group and member data to support accurate eligibility and account management
- Resolved complex file discrepancies during system transitions, ensuring seamless member migration across platforms
- Collaborated cross-functionally to verify and maintain the accuracy of member account information
- Validated member ID cards and billing statements to uphold data integrity and prevent service issues
- Reviewed and corrected errors in daily system reports, contributing to operational efficiency and compliance
Small Group Underwriter
Blue Shield of California
12.2013 - 01.2015
- Collected, reviewed, and analyzed data to underwrite new and renewal group medical policies, including issuing contract amendments
- Identified and requested missing documentation from sales teams, brokers, and group contacts to complete underwriting files
- Assessed group eligibility and made approval or denial decisions in alignment with Federal, State, and Blue Shield guidelines
- Ensured timely review and processing of cases to meet internal service standards and regulatory requirements
- Updated internal systems, documents, and spreadsheets to accurately reflect underwriting decisions and case outcomes
- Evaluated employer and employee data to verify eligibility, identify discrepancies, and detect potential misrepresentation in standard cases
Rate Analyst
Blue Shield of California
09.2010 - 12.2013
- Liaised with Producers, Sales, and other stakeholders to obtain missing documentation and ensure case completeness
- Processed assigned cases efficiently and accurately, consistently meeting defined performance goals
- Entered case data into internal systems with precision, maintaining integrity and timeliness across databases
- Demonstrated strong decision-making, analytical thinking, and data entry skills in a fast-paced environment
- Communicated clearly and concisely, both verbally and in writing, to support cross-functional collaboration
- Evaluated employer and employee information to confirm eligibility and identify discrepancies or potential misrepresentation
- Reviewed and scrubbed new group case documents for completeness and compliance with underwriting standards
- Applied basic math concepts to calculate figures and validate financial data relevant to case processing
Medicare Processor
Blue Shield of California
02.2006 - 09.2010
- Processed member enrollments and health plan applications with a high level of accuracy and attention to detail
- Reviewed applications for completeness and eligibility, requesting medical documentation when necessary
- Made approval decisions or escalated applications to underwriting in accordance with Blue Shield policies and applicable federal/state regulations
- Collected and submitted underwriting documentation promptly to designated contacts to support timely case resolution
- Communicated effectively with brokers, underwriters, and sales teams to ensure smooth application processing
- Entered and retrieved data using standard systems and keyboard functions, maintaining data integrity across platforms
- Consistently met tight deadlines while adhering to detailed procedural guidelines
- Interpreted technical procedures and government regulations to ensure compliance and accurate processing
- Composed professional business correspondence and provided clear, responsive communication to brokers, agents, and internal staff
Guaranteed Issue Processor
Blue Shield of California
03.2004 - 02.2006
- Conducted in-depth research to determine applicant eligibility and explore alternative coverage options
- Entered, logged, and tracked application data across systems to ensure accuracy and timely follow-up
- Evaluated and approved or declined applications in accordance with established guidelines and regulatory standards
- Managed all correspondence related to application processing, maintaining clear and professional communication
- Provided responsive support to producers and brokers via phone, fax, and email to facilitate smooth case resolution
Education
High School Diploma -
Manteca High School
Manteca, CA01.1998
Certificate - Medical Assisting
MTI College
Sacramento, CA01.2003
Skills
- Microsoft office
- Customer service
- Attention to detail
- Multitasking and organization
- Team collaboration
- Data entry proficiency
- Client relationship management
- Data research
- Time management
- Problem-solving
- Reliability
- Organizational skills
- Professional communication
Timeline
Billing Representative
Wollborg Michelson for Blue Shield of California
10.2021 - 11.2021
Administrative Assistant III
Health Plan of San Joaquin
11.2015 - 09.2016
Superuser Group Processor
Randstad Professionals for Blue Shield of California
05.2015 - 09.2015
Small Group Underwriter
Blue Shield of California
12.2013 - 01.2015
Rate Analyst
Blue Shield of California
09.2010 - 12.2013
Medicare Processor
Blue Shield of California
02.2006 - 09.2010
Guaranteed Issue Processor
Blue Shield of California
03.2004 - 02.2006
High School Diploma -
Manteca High School
Certificate - Medical Assisting
MTI College
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