Jazzmene Thomas
HUMBLE
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.
Overview
13
13
years of professional experience
Work History
Care Coordinator
Included Health
12.2022 - Current
- Averaging 50 incoming chats to assist Google members with their health questions.
- Documented customer interactions and transactions for accurate, up-to-date records.
- Fielded customer complaints, escalating complex issues to management for resolution.
- Assessed customer needs and recommended suitable benefit options.
- Advised customers on required information for claim submissions to progress applications.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery
Medical Claims Specialist
United Healthcare Group
02.2022 - 12.2022
- Maintained strict confidentiality with all personal data as per company guidelines.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Examined claims forms and other records to determine insurance coverage.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Lab Technician - COVID-19 Unit
WellStreet Urgent Care
10.2021 - 02.2022
- Used employer-provided Personal Protective Equipment to reduce risk of getting or spreading COVID-19 to others.
- Determined or developed advanced research methods and procedures to accomplish required goals.
- Operated, maintained and repaired highly complex research instruments and equipment.
- Stored and disposed of various samples and hazardous materials using prescribed methods.
Closing Coordinator
Amrock
09.2020 - 10.2021
- Established positive flow of communication with agents, clients, attorneys and personnel involved in closing transactions.
- Reviewed and executed confidential documents, contracts and disclosures..
- Collaborated with attorneys, loan officers and agencies to complete property sales and purchases and thoroughly explained all financial requirements and data to potential buyers and sellers.
- Verified closing financial disclosure amounts against settlement and escrow agent figures to accurately reflect borrowers' bottom-line costs.
Interim Administrator
Presbyterian Villages Of Michigan Foundation
10.2019 - 09.2020
- Supervised 100-unit senior living facility and staff of 6-10 employees.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Updated reports, managed accounts, and generated reports for company database.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Established workflow processes, monitored daily productivity, and implemented modifications to improve overall performance of personnel.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals.
Patient Access Representative
UT Health
03.2019 - 09.2019
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
County Clerk
Wayne County Michigan
08.2017 - 11.2018
- Lead marriage specialist where I maintained marriage records for Wayne County.
- Stayed up-to-date on Michigan laws and licensing requirements to complete accurate and efficient reviews.
- Provided marriage, death, birth and assumed name searches and/or certifications for Wayne County.
- Assisted newly hired clerks in learning about application reviews and verification procedures, performance strategies and customer service techniques.
- Verified authenticity of foreign identification or immigration documents.
Referral Specialist
St. John Providence Health System
03.2015 - 08.2017
- Verified insurance benefits and eligibility for specialist and outpatient procedures before referring clients.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Coordinated with medical staff and patients to find cost-effective options for services.
- Monitored referrals to foster timely completion and followed up with physicians to facilitate.
Office Administration Manager
St. Claire Shores Medical
08.2011 - 03.2015
- Secured optimal program efficiency through collaboration with internal teams and development of positive community relationships.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Coordinated communications, financial processing, registration, recordkeeping, and other administrative functions.
- Tracked office supplies and restocked low items to keep team members on-task and productive.
- Applied advanced administrative and analytical skills in overseeing day-to-day operational activities.
Education
Bachelor of Science - Psychology
Capella University
2025
Associate of Applied Science - General Studies
Macomb Community College
Warren, MI2014
High School Diploma - undefined
East Detroit High School
Eastpointe, MI2013
Skills
- Claim Validity Determination
- Interpretation Skills
- Benefits Guidelines
- Medical Terminology
- Data Entry
- Medical Billing and Coding
Timeline
Care Coordinator
Included Health
12.2022 - Current
Medical Claims Specialist
United Healthcare Group
02.2022 - 12.2022
Lab Technician - COVID-19 Unit
WellStreet Urgent Care
10.2021 - 02.2022
Closing Coordinator
Amrock
09.2020 - 10.2021
Interim Administrator
Presbyterian Villages Of Michigan Foundation
10.2019 - 09.2020
Patient Access Representative
UT Health
03.2019 - 09.2019
County Clerk
Wayne County Michigan
08.2017 - 11.2018
Referral Specialist
St. John Providence Health System
03.2015 - 08.2017
Office Administration Manager
St. Claire Shores Medical
08.2011 - 03.2015
Bachelor of Science - Psychology
Capella University
Associate of Applied Science - General Studies
Macomb Community College
High School Diploma - undefined
East Detroit High School