Open To Work
Jamese Lofton
Independent Contractor
Fort Lauderdale,FL
Work Preference
Job Search Status:
Open to work
Location Preference
Remote
1
Certification
9
years of professional experience
Dynamic Benefits Professional with 7+ years of experience in healthcare operations and insurance verification. Proven track record in Client Relationship Management and Benefits Consulting within high-volume environments. Expert at utilizing Salesforce and CRM platforms to guide clients through complex insurance plans while maintaining 100% compliance and accuracy.
Work History
Patient Care Assistant
11 Months- Review client accounts and insurance records to support high-accuracy Benefits Consulting and claims resolution.
- Verify member eligibility and coverage through systematic Outbound Calling and coordination with payer networks.
- Log all client discrepancies and coordinate timely resolution using Salesforce and CRM data entry workflows.
- Support Remote Work Operations by maintaining detailed documentation for reimbursement and utilization review.
- Guide stakeholders through complex healthcare information while ensuring strict HIPAA compliance.
Benefits Advisor
8 Months- Managed Client Relationship Management by verifying insurance coverage and member benefits across multiple plans.
- Log and resolved claims-related issues through detailed account investigation and accurate resolution protocols.
- Built long-term client trust by investigating account concerns and maintaining meticulous case documentation.
- Supported high-volume benefits administration and issue resolution in a fast-paced virtual environment.
Intake Coordinator
2 Years 2 Months- Executed Lead Generation activities by collecting and verifying patient demographic and insurance information.
- Guided prior authorization requests and reviewed documentation to ensure completeness for reimbursement.
- Log and maintained accurate EMR records to support revenue cycle management and care coordination.
- Collaborated with providers and patients to resolve insurance-related issues through Client Acquisition support.
Patient Care Representative
1 Year 11 Months- Managed Data Entry for claims-related documentation and reviewed patient records for system accuracy.
- Performed Outbound Calling to verify insurance eligibility and benefits for billing and claims workflows.
- Investigated billing and claims discrepancies while maintaining peak quality standards and client satisfaction.
- Maintained strict compliance with HIPAA regulations and diverse payer requirements for insurance sales support.
Education
Associate of Science
Skills
Claims Adjudication
Claims Processing & Resolution
Benefits Administration
Health Insurance Claims
Medical Claims Review
Claims Investigation
Claims Analysis
Claims Validation
Coverage Verification
Eligibility Verification
Benefit Plan Interpretation
Policy Review
Prior Authorization
Appeals & Grievances Processing
Denial Management
Payment Accuracy Review
Typing proficiency: 45 wpm
Certification
- Certified Clinical Medical Assistant (CCMA) - Stepful (2023-01)
- BLS Certification - American Heart Association (2023-05)
Timeline
Patient Care Assistant
Independent Contractor
08.2025 - CurrentRead More
Benefits Advisor
Sutherland
08.2024 - 04.2025Read More
Intake Coordinator
Total Orthopedics & Sports Medicine
03.2021 - 05.2023Read More
Patient Care Representative
Call 4 Health
12.2017 - 11.2019Read More
Stepful
Associate of Science
Read More