Jaimie Rogers
Mount Pleasant,Texas
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims. Organized Clinical Coordinator with excellent scheduling, coordination and documentation talents as part of clinical teams. Skilled at admitting patients, managing patient services, providing thorough reports, and ensuring patient satisfaction. Detail and patient-oriented with proficiency in handling emergency situations. Administrative leader offering experience prioritizing and delegating administrative tasks to drive goal achievement. Proficient in schedule coordination, resource allocation, and office supply inventory management. Dedicated to training and mentoring top talent while cultivating a productive work culture.
Overview
10
10
years of professional experience
Work History
Associate Clinical Administrative Coordinator
Optum
05.2023 - 07.2024
- Answered up to 150 phone calls per day, addressing inquiries from customers, vendors, and other external contacts with professionalism and efficiency
- Facilitated smooth day-to-day operations by anticipating needs, proactively addressing potential issues, and resolving problems in a timely manner
- Identified and implemented opportunities for improving administrative processes, resulting in increased efficiency and effectiveness
- Increased team productivity through effective task delegation and prioritization of responsibilities
- Contributed to a positive work environment by addressing employee concerns and fostering open communication
- Enhanced customer satisfaction by handling inquiries and concerns promptly and professionally
- Ensured compliance with company policies through regular audits and up-to-date knowledge of regulations
- Improved interdepartmental communication with accurate and timely preparation of reports and documents
- Greeted visitors professionally and directed them to the appropriate departments
- Overcame workflow challenges with innovative solutions, improving overall team performance
- Streamlined office operations by implementing efficient administrative processes and procedures
- Supported clinical staff by coordinating schedules, handling appointment confirmations, and updating patient records as needed.
- Responded to patient inquiries via phone and email, providing accurate information and resources while maintaining a professional demeanor.
- Coordinated schedules with patients and facility calendar.
Clinical Coordinator
Tulia MD
12.2021 - 11.2022
- Mentored new clinical staff members, guiding them through onboarding and orientation processes to ensure smooth integration into the team
- Collaborated with clinic administrators to maintain a safe, clean, and organized environment for optimal patient care
- Enhanced interdisciplinary collaboration through effective communication and coordination among healthcare team members
- Developed strong relationships with community partners to expand support services for patients beyond the clinical setting
- Ensured compliance with regulatory standards and best practices by overseeing clinical procedures, documentation, and staff training
- Coordinated, monitored, and documented patient and clinical care activities to ensure high-quality service delivery
- Implemented new policies and educated staff on changes, facilitating seamless transitions and adherence to updated procedures
- Organized continuing education opportunities for staff members, keeping them current on industry advancements and best practices
- Streamlined processes to improve patient care delivery, reducing wait times and enhancing overall satisfaction
- Developed strong relationships with community partners to enhance support services available for patients beyond the clinical setting.
- Supervised and managed daily activities of clinical team consisting of 15 physicians, nurses, and support staff.
Medical Claims Specialist
Tulia MD
12.2021 - 11.2022
- Processed and tracked requests for medical records from external organizations, ensuring timely and accurate information exchange
- Managed medical records with confidentiality, adhering to HIPAA regulations and maintaining high data accuracy
- Handled various types of medical claims across multiple specialties, demonstrating adaptability while maintaining accuracy
- Documented patient conditions and treatments, coding medical claims for hospitals and nursing facilities
- Assessed medical claims for compliance with regulations, correcting discrepancies and ensuring accurate submissions
- Obtained over 30 prior authorizations and pre certifications for outpatient procedures daily, efficiently managing requests and ensuring timely approvals
- Provided empathetic support to patients navigating complex medical systems, offering guidance throughout the prior authorization process
- Maintained consistent follow-up on the status of prior authorization requests, improving patient satisfaction through effective management
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Improved claim processing efficiency by streamlining workflows and implementing best practices.
- Monitored outstanding accounts receivable balances for trends that could indicate payer issues or potential collection problems.
- Achieved timely reimbursements for clients through keen understanding of insurance company protocols.
- Effectively resolved claim disputes by conducting thorough investigations and presenting findings to stakeholders clearly and concisely.
- Managed high volume of claims, consistently meeting deadlines without compromising accuracy or quality.
- Negotiated payment plans for patients facing financial hardships, minimizing revenue loss while maintaining empathetic customer service.
- Utilized advanced knowledge of ICD-10 codes to accurately process complex medical claims.
- Submitted electronic/paper claims documentation for timely filing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Co-Owner
Rogers Auto Works
01.2015 - 12.2021
- Managed day-to-day business operations, ensuring all tasks were completed accurately and efficiently by team members
- Developed and maintained strong relationships with clients, resulting in repeat business and referrals
- Increased customer satisfaction by implementing efficient business processes and providing exceptional service
- Managed financial aspects of the business, including budgeting, financial reporting, and tax preparation
- Consulted with customers to assess needs and propose optimal solutions, enhancing client satisfaction and loyalty
- Hired, trained, and managed a high-performing team of 7 employees, leading them to achieve company goals
- Trained and motivated employees to perform daily business functions effectively
- Implemented marketing strategies to increase brand awareness and attract new customers
- Established a positive workplace culture that fostered employee engagement, collaboration, and loyalty
- Negotiated contracts with suppliers for better pricing and terms, reducing overall costs for the business
- Evaluated suppliers regularly to maintain cost controls and improve operations
- Established foundational processes for business operations to streamline workflow and increase efficiency
- Organized and attended trade shows and special events to showcase products, network with other businesses, and attract new customers
- Evaluated industry competition regularly to maintain a competitive advantage in the marketplace
Education
Associate's Degree - Nursing
Northeast Texas Community College
Mount Pleasant, Texas05.2020
High School Diploma -
Pittsburg High School
Pittsburg, Texas05.2010
Skills
- HIPAA knowledge
- Telephone Customer Support
- Clinical Documentation
- Patient Scheduling
- Medical Terminology
- Healthcare Education
- Patient Care
- Assessment
- Clinical Procedures
- Multitasking
- Team Leadership
- Training and Development
- Project Management
- Patient Advocate
- Credentialing
- Application Processing
- Contract Negotiation
- HIPAA knowledge
- Telephone Customer Support
- Medicare/Medicaid
- Clinical Documentation
- Patient Scheduling
- Medical Terminology
- Healthcare Education
- Patient Care
- Assessment
- Clinical Procedures
- Multitasking
- Team Leadership
- Training and Development
- Project Management
- Patient Advocate
- Credentialing
- Application Processing
- Contract Negotiation
- HIPAA knowledge
- Telephone Customer Support
- Medicare/Medicaid
- Clinical Documentation
- Patient Scheduling
Timeline
Associate Clinical Administrative Coordinator
Optum
05.2023 - 07.2024
Clinical Coordinator
Tulia MD
12.2021 - 11.2022
Medical Claims Specialist
Tulia MD
12.2021 - 11.2022
Co-Owner
Rogers Auto Works
01.2015 - 12.2021
Associate's Degree - Nursing
Northeast Texas Community College
High School Diploma -
Pittsburg High School
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