Jennifer Hernandez
Arlington
Summary
Dynamic professional with extensive experience at Molina Healthcare Inc., excelling in insurance verification and medical records management. Proven problem-solver with a keen attention to detail, adept at enhancing processes for improved accuracy and efficiency. Proficient in EMR systems and medical coding, delivering quality assurance in high-stakes environments.
Overview
10
10
years of professional experience
Work History
COB processor
Molina Healthcare Inc.
04.2022 - 07.2025
- Insurance Verification of Medicare, Tricare, and all Commerical Insurances.
- Processing Insurance for Coordination of Benefits.
- Claim Review, Recovery Identification, Optum Revalidations, COB Intakes
Medical records collector
Molina Healthcare Inc.
10.2015 - 04.2022
- Conducted research to locate members charts for specific services for HEDIS measures with 98% accuracy.
- Retrieval of Medical records from providers, medical groups, hospitals and vendors.
- Lead in Quality HEDIS department
- Assist in training on all pursuit and retrieval processes
- Manage escalated issues received from vendors
- Worked in multiple EMR systems retrieving medical records
- Processed incoming medical records
- Participated in meetings with Vendors for retrieval of medical records
- Identified and recommended changes to existing processes to improve accuracy, efficiency and quality services.
- Function as a team leader for Risk Adjustment, RADV, and CMS Audits
- Coordinate HEDIS and RADV Audits for Central, Southern and Eastern regions
Education
Medical Insurance Coding -
Ashworth College
09.2025
Skills
- Problem-solving and resolution
- Attention to detail
- Organizational skills
- Multitasking abilities
- Analytical thinking
- Project management
- Data entry proficiency
- Medical coding
- Quality assurance
- Managed care knowledge
- Health information management
- Claims processing
- EMR/EHR systems
- Medical terminology
- Microsoft Office suite proficiency
- Excel and Visio expertise
- PowerPoint presentation skills
- CPT, HCPCS, ICD-9/10
- Access and SharePoint experience
- NitroPro10
- Customer service
Timeline
COB processor
Molina Healthcare Inc.
04.2022 - 07.2025
Medical records collector
Molina Healthcare Inc.
10.2015 - 04.2022
Medical Insurance Coding -
Ashworth College
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