Jameelah Williams

• Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
• Verified insurance eligibility and coverage for patients.
• Promptly and professionally answers telephone calls (as well as retrieve messages that are received via answering service). Route calls appropriately, offering voicemail, paging, or redirection of calls as needed.
• Greet patients/visitors and assist and direct them accordingly. Phone or page employees to meet visitors, directs visitors to appropriate waiting areas, and appropriately and courteously screen solicitors for relevance to organizational needs.
• Explain financial requirements to patients; collect and record copays as required.
• Perform registration functions for new and existing patients.
• Schedule patient appointments per guidelines given and finalize patient schedules for previous day.
• Maintain confidentiality regarding all patients.
• Adhere to infection control/safety guidelines and confidentiality policies through HIPAA compliance.
• Other duties as assigned.
• Improved patient satisfaction by providing exceptional customer service during check-in and check-out processes.

• Responsible for investigation, determination and reporting of claims processing thru auditing of normal business processes as well as handling second level appeal requests Reviewing and investigating claims and encounters for medical, facility, pharmacy, dental and vision services including contractual provisions, authorizations and Health Policy and Procedure
• Subsequent auditing and handling of specific claims and appeal requests including processing where applicable, tracking, documenting, reporting and dispersal of findings and recommendations
• Identifying defects and improving departmental performance by supporting quality, operational efficiency and production goals
• Reporting and presenting preliminary findings based on trending and interpretation
• Trending and comparing analyses against departmental and corporate standards
• Assist with developing and participating in effective training and documentation.
• Reduced claim resolution time by conducting thorough investigations and timely decision making.
• Mitigated company risk by identifying fraudulent activities and implementing preventative measures.
• Examined claims forms and other records to determine insurance coverage.
• Directed claims negotiations within allowable limit of and supported successful litigations for advanced issues.
• Developed and maintained relationships with key stakeholders, fostering a cooperative working environment.

• Handle benefit, eligibility, and claims inquiries via telephone or written correspondence
• Answer questions and resolve issues based on phone calls from members, providers, and plan sponsors
• Triage work to appropriate staff/business areas as needed
• Document interactions with members, and providers
• To track contact reasons and trending
• Ability to adhere to corporate policies/procedures; remain current on industry data
• Perform thorough review of claims history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
• Use applicable system tools and resources to produce quality letters in response to inquiries received
• Deliver world class service at all times to both internal and external customers.

• Handle benefit, eligibility, and claims inquiries via telephone or written correspondence
• Answer questions and resolve issues based on phone calls from members, providers, and plan sponsors
• Triage work to appropriate staff/business areas as needed
• Document interactions with members, providers or etc
• To track contact reasons and trending
• Ability to adhere to corporate policies/procedures; remain current on industry data
• Perform a thorough review of claims history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
• Use applicable system tools and resources to produce quality letters in response to inquiries received
• Deliver world class service at all times to both internal and external customers.
• Established a positive work environment that encouraged collaboration and teamwork among staff members for optimal results.

• Registering patients, explaining forms, taking copays
• Collecting demographics and health history
• Assigning beds, admit, transfer and discharging patients
• Insurance authorizations, Knowledge of MS Office (MS Word, Excel, Outlook)
• Knowledge of various insurance plans HMO, PPO, POS, Medicare and Medicaid
• Responsible for inbound / outbound calls
• Knowledge of Navinet, Invision, Epic and T-System programs, scanning, faxing, filing, inbound and outbound calling, collecting copays.

Welcomed as many as 100-200 patients daily, directing to appropriate departments within facility and coordinating assistance with transportation.

• Cleaned bathrooms, patient rooms, waiting rooms, offices and public areas
• Sanitized and disinfected surfaces, sinks, fixtures, beds, walls toilets and floors
• Discharged rooms, dusted, vacuumed, garbage pickup and disposal.
• Collaborated with cross-functional teams to ensure timely completion of projects related to facility maintenance and improvements.
• Maintained a safe working environment through consistent adherence to safety protocols and regulations.
• Supported infection control measures by ensuring proper sanitization of all areas within the healthcare facility.
• Streamlined inventory management processes to minimize stock shortages and reduce costs associated with excess supplies.
• Managed hazardous waste disposal according to local regulations, minimizing potential risks to personnel and the environment.