Jennifer Marra
851 Silver Lake Scotchtown Rd Middletown,NY
Summary
- To obtain a position in a growing company to utilize training gained in current and previous companies.
- 11 Years experience in Healthcare setting
- 10 Years experience in Customer Service in the Health Insurance Field.
Overview
21
21
years of professional experience
Work History
Authorization Associate
Optum UHC Group
08.2019 - 03.2024
- Obtain pre-certifications for patients scheduled within the practice for CT scans and MRI's on a daily basis.
- Verify procedures that are being ordered are covered with in required guidelines
- Ensure providers are completing their Peer Reviews
- Verify patient insurance eligibility and coverage conditions on patient insurance when indicated.
Provider Resources Associate
Crystal Run Healthcare LLP
07.2014 - 07.2019
- Provide accurate and timely credentialing and re-credentialing of new and existing medical providers in accordance with Joint Commission requirements, and with all outside organizations/entities
- Ensure that licensure in every state and jurisdiction, federal registrations and board certifications remain intact and are current
- Credential new and existing providers with outside Hospitals
- Credential new and existing providers in various Health Care plans
- Maintaining computer and manual filing systems for over 400 providers; retrieve files as needed
- Sets up and maintains provider information in online credentialing databases and system
- Ensure delegated Insurance plans have all required information and documentation to enroll providers in insurance
- Carrying administrative duties and other duties as assigned.
Authorization Associate
Crystal Run Healthcare LLP
06.2012 - 07.2014
- Obtain pre-certifications or pre-determinations for patients scheduled outside and within the practice for CT scans on a daily basis
- Verify procedures that are being ordered are covered with in required guidelines
- Ensure providers are completing their Peer Reviews
- Verify patient insurance eligibility and coverage conditions on patient insurance when indicated.
Employer Service Representative
Wellpoint Inc., Empire BlueCross BlueShield
03.2005 - 04.2012
- Experienced Service Representative focused on Customer Advocacy
- Liaison for 9 National Account clients
- Resolve high-level member issues, proactive in continuous improvement and ensuring efficient claims processing and accuracy
- Expertise in medical terminology and medical coding: CPT 200 and ICD-9
- Fluent in Medical Policy/HIPAA Compliance/Medicare
- Partner in annual client meetings and Health Benefit Fairs
- Analyze business reports to identify system improvements focused on exceeding client expectations.
Customer Service Representative
Wellpoint Inc., Empire BlueCross BlueShield
10.2002 - 03.2005
- Handle inbound customer calls regarding medical insurance benefits and claims processing inquiries.
Education
High School Diploma -
Pine Bush High School
Pine Bush, NY08.1993
Skills
- Excellent attention to detail
- Extensive experience with Joint Commission standard
- Possesses strong communication and intrapersonal skills with drive to help out wherever it is required to get the task at hand done
- Enjoys challenges and researching solutions Able to work well under pressure as well as in a team setting
Training
- Microsoft Word and Excel
- MDStaff
- NextGen
- Symed
- Joint Commision
- HIPPA Compliance
- Trained in ICD-9, ICD-10 and procedure codes
- Trained in Health & Compliance and Health Care Reform
- Mental Health Parity
- Microsoft Office Word and Excel
- NASCO and CS90 claims processing platforms
- Syngo
Timeline
Authorization Associate
Optum UHC Group
08.2019 - 03.2024
Provider Resources Associate
Crystal Run Healthcare LLP
07.2014 - 07.2019
Authorization Associate
Crystal Run Healthcare LLP
06.2012 - 07.2014
Employer Service Representative
Wellpoint Inc., Empire BlueCross BlueShield
03.2005 - 04.2012
Customer Service Representative
Wellpoint Inc., Empire BlueCross BlueShield
10.2002 - 03.2005
High School Diploma -
Pine Bush High School
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