JALEIK RIVERS
West Babylon
Summary
Experienced with intake processes, client assessments, and care coordination. Utilizes strong communication and organizational skills to ensure seamless client management. Track record of developing and maintaining effective working relationships with clients and team members.
Overview
6
6
years of professional experience
Work History
Intake Case Manager
Samaritan Village
04.2024 - 01.2025
- Client Screening, Review client documents to determine needs, complete intake process by actively listening to coordinate services needed, provide referrals as needed
- Work closely with homeless patients, to verify a multitude of things to better understand the client’s situation and help them leave the shelter
- Independent Living Plans (ILP) are conducted weekly or Bi-weekly; these meetings involve exploring the clients background as far as their medical, housing, benefits and explaining the rules and regulations of what’s required at Samaritan village
- All client information is uploaded on a website called DHS cares, once uploaded, we complete progress notes of the entire ILP discussion that took place
- We keep track of these by having the client sign the document and giving them their own copy
- The company is big on compliance and making sure that any rule breaking on the client behalf will not be tolerated; if the client misses more than three ILP’, we note it down in cares for either a final review meeting or transferring the client
- Wellness checks and room checks are a huge part of Samaritan village, making sure the clients are mentally well and their rooms are harboring any illegal weapons or items
- We must report in our ILP’s if this happens and keep track of how many times it happens
Case Auditor
Northwell Health
08.2023 - 03.2024
- Verify patients' insurance information for scheduled procedures, ensuring accuracy and completeness in the hospital and internal systems
- Conduct thorough checks to ensure patients' account names match their insurance cards; promptly communicate with patients via phone or email to obtain updated insurance information if discrepancies arise
- Scan accounts for healthcare providers to confirm insurance validity; process accounts accordingly for procedures with active insurance coverage, sending them to the verification department for further processing
- Review patient files to investigate cases of inactive insurance
- Proactively engage with patients to secure timely updates to their insurance information before procedures to avoid out-of-pocket expenses, leveraging strong communication skills and attention to detail
Case Auditor
MTK Resources
01.2023 - 06.2023
- Evaluated loan applications for businesses in Texas, ensuring compliance with legal requirements and company policies
- Conducted comprehensive reviews of all sections of tax applications to verify alignment with customers' legal documents
- Utilized SharePoint and the Texas Travel Industry Recovery (TTIR) websites to access and process applications, ensuring accuracy and completeness
- Enforced strict guidelines requiring signatures and dates on all federal tax forms before application review
- Implemented eligibility criteria, including matching information, complete documentation, and evidence of sales loss within the past three years (2019-2021), to qualify for a $20,000 loan
Pharmacovigilance
Amneal Pharmaceuticals
10.2021 - 12.2022
- Report quality control and medical analysis for both brand and generic products and review each case utilizing case data to draw causal relationships and to formulate accurate recommendations
- Utilize both IRMS and QUMAS systems to input data and find case history information for marketed products and investigational compounds, following SOPs to meet compliance requirements
- Responsible for providing oversight to vendors for data entry and processing and report all adverse events received by the organization to regulatory compliance agencies
- Manage 12 cases a day, process returns for customers/vendors, generate return labels/refunds through UPS, document details in the workflow management system, and manage cases to final resolution
Clinical Practice Plan Representative
Northwell Health
01.2019 - 03.2020
- Processed patient information for accurate medical billing and coding, including recording private payment details, resolving discrepancies, and updating insurance records
- Provided on-site assistance to patients regarding account and payment inquiries, delivering financial counseling to expedite resolutions
- Verified insurance coverage, collaborated with hospital registrars to authorize treatment, and fulfilled insurance carrier requests for documentation, ensuring protocol compliance
- Analyzed and reviewed an average of 50 patient accounts daily, addressed physician inquiries, and contacted patient’s post-procedure in cases of denied insurance coverage
Education
Bachelor of Arts - Psychology
SUNY Old Westbury
Old Westbury, NY05.2017
Skills
- Debt Collection
- Individual Case Safety Report (ICSR)
- Medical Billing & Coding
- Data Entry & Financial Counseling
- Manage Workflows
- Collections & Record Mgt
- Microsoft Office Suite
- GECB
- QUMAS
- IRMS
- AllScripts
- Eagle
- EncoderPro
- Invision
- Soarian
- Stockamp & Financials (Data System)
- RIS/SYNGO
- Connex
- Epaces
- Supercoder
- Keane
- Follow-up skills
- Case assessment
Additional Information
Worship Christian Center, Volunteer, Food Pantry & Coat Drive, Volunteer, Youth Coach, Freelance Artist & Script Writer
Timeline
Intake Case Manager
Samaritan Village
04.2024 - 01.2025
Case Auditor
Northwell Health
08.2023 - 03.2024
Case Auditor
MTK Resources
01.2023 - 06.2023
Pharmacovigilance
Amneal Pharmaceuticals
10.2021 - 12.2022
Clinical Practice Plan Representative
Northwell Health
01.2019 - 03.2020
Bachelor of Arts - Psychology
SUNY Old Westbury
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