Jamal Sneed
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
25
25
years of professional experience
Work History
Medical Biller
Hydra Medical Billing
07.2023 - Current
- Manage daily operations, including billing, coding, and claim submissions for medical services rendered.
- Ensure compliance with healthcare regulations and insurance requirements to minimize claim denials and maximize revenue.
- Provide personalized customer service, resolving billing inquiries and discrepancies to maintain positive relationships with clients and patients.
Claims Examiner
Healthfirst
10.2021 - 06.2023
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Collaborated with insurance adjusters to expedite claim settlements, ensuring fair resolutions for all parties involved.
- Interpreted policy provisions, endorsements, and exclusions to accurately determine coverage for claims.
Health Benefits Call Center Unit Manager
32BJ Health Fund
08.2003 - 10.2021
- Supervise 7 full time employees who handle inbound and outbound calls related to all aspects of health benefits including eligibility, billing, and provider searches
- Ensure smooth transition from in-person work to remote-work without a disruption in service to plan participants
- Develop outbound call campaigns to help plan participants best use their benefits
- Ensure employee excellence through continuous quality audits and oversee ongoing corrective actions and training to improve audit scores
- Developed new reporting tools to quantify excess capacity in call center and reallocate workflows accordingly
- Analyze all unit processes on an ongoing basis to determine their effectiveness, eliminate inefficiencies and make changes to improve on identified inefficiencies
- Coordinate plan participant support with Third Party Administrator
- Serve as internal expert on benefits rules, claims processing and utilization and case management processes
- Develop joint workflows to ensure that plan participants have seamless and timely access to care
- Intake workflows for members with chronic conditions who would benefit from Fund programs
- Ensure timely response to plan participants who are seeking care from out of network and non-preferred providers
- Support Fund Director in authorizing out of network care at in-network cost sharing rates when in-network care is not available
- Serve as unit liaison to the IT and Business Development department on related matters
- Serve as the learning leader for the department to train current staff on new tools and workflows
- Developed the CRM implementation plan to consolidate data across the funds and Empire BCBS systems
- Configured and customized the CRM automation process for staff to save time for more critical tasks
- Created onboarding process and documentation for new CRM users
- Tested CRM system through creating test cases for data conversion, functionality, and integration.
Assistant Coach/Personal Trainer
Krank
01.2017 - 03.2019
- Assisted in physical training program development and delivery: Performed fitness assessments, including calculating BMI, body weight and fat measurements and evaluated member's needs and goals; led various group exercise classes and 1 on 1 personal training sessions; encouraged member safety in training sessions by providing appropriate modifications to movements when needed
- Developed a new employee timekeeping system that increased the efficiency of the previous process
- Created an inventory system that provides insight into inventory levels, costs and revenue earned per item sold.
Intake Specialist
NYCHSRO MedReview
09.1999 - 08.2003
- Verified patient eligibility for insurance and resolved any issues
- Set up prior authorization and reviewed medical records to identify diagnoses and procedures
- Organized and prioritized all work to ensure that delivery of medications and supplies and nursing visits were on schedule.
Education
Health Administration - Health Administration
Borough of Manhattan Community College
NY, NY01.2011
Skills
- Employee Development
- Operations Management
- Project Management
- Staff Management
- Team Oversight
- Customer Relations
- Staff hiring
- Relationship Building
- Customer Service
- Employee Training
- Quality Assurance
- Policies and Procedures Development
Timeline
Medical Biller
Hydra Medical Billing
07.2023 - Current
Claims Examiner
Healthfirst
10.2021 - 06.2023
Assistant Coach/Personal Trainer
Krank
01.2017 - 03.2019
Health Benefits Call Center Unit Manager
32BJ Health Fund
08.2003 - 10.2021
Intake Specialist
NYCHSRO MedReview
09.1999 - 08.2003
Health Administration - Health Administration
Borough of Manhattan Community College