Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Jennifer Stouffer

Pittsburgh ,PA

Summary

Accomplished Care Navigator with a proven track record at Optum for enhancing patient outcomes through meticulous care coordination and effective communication. Skilled in patient confidentiality and demonstrating empathy, successfully reduced hospital readmissions. Expert in healthcare systems and a dedicated community advocate, consistently achieving excellence in patient care and support.

Compassionate Patient Navigator with a distinguished understanding of insurance processes and medical billing. Adept at patient and family education and paying attention to details. Successful at building relationships with clients.

Overview

17
17
years of professional experience

Work History

Care Navigator/Senior Clinicial Admin Coordinator

Optum
02.2019 - Current
  • Consistently maintained confidentiality while handling sensitive patient information in accordance with HIPAA guidelines.
  • Identified potential barriers to care, implementing tailored solutions to improve outcomes.
  • Maintained detailed documentation of patient interactions, treatment plans, and progress notes for accurate recordkeeping.
  • Complete assessments for HRA/CAHPS/SDOH
  • Meet CMS requirements.
  • Educated member on gaps in care and assisted with scheduling provider appointments.
  • Assisted members with social determinants of health and linked to appropriate community resources.
  • Managed complex cases, ensuring timely access to appropriate resources and services.
  • Exceeded program metrics including an average call/chart audit score of 95%, 30 calls per day, and a total talk time of 30%

Senior Reimbursement Counselor

Lash Group
01.2015 - 02.2019
  • Coordinated with healthcare providers to ensure accurate information is submitted during appeals process for denied claims, leading to successful resolutions.
  • Effectively negotiated contracts with third-party payers, securing favorable terms for organizational profitability.
  • Streamlined reimbursement processes by implementing efficient tracking and reporting systems.
  • Served as a trusted resource for colleagues seeking guidance on reimbursement policies or procedures.
  • Experience with CPT, HCPCS, ICD-10 coding, revenue code, and billing/claims processing.

Patient Coordinator

Lash Group
03.2008 - 01.2015
  • Increased efficiency of the front office operations through effective multitasking, attention to detail, and organization skills.
  • Provided excellent customer service to all patients, addressing concerns and answering questions promptly and professionally.
  • Handled sensitive situations with empathy when dealing with distressed patients or those facing serious health challenges.
  • Maintained up-to-date knowledge on insurance policies, medical terminology, and clinic protocols in order to provide accurate information and assistance to patients.

Education

Associates Degree - Tourism And Hospitality Management

Sawyer School
Pittsburgh, PA
05-1999

Skills

  • Patient confidentiality
  • Data analyst
  • Care coordination
  • Resource identification
  • Medical billing
  • Insurance expert
  • Multitasking
  • Outbound calling
  • Medical insurance
  • Documenting and recording information
  • Detail-oriented
  • Caring and empathetic
  • Active listening
  • Team collaboration
  • Calm and effective under pressure
  • Healthcare
  • Community advocate
  • Medical terminology

Accomplishments

  • M & R 2
  • Leadership Foundations Program 2023
  • NPS Champion 2023
  • Culture Ambassador 2022
  • Superhero Nomination 2021

Timeline

Care Navigator/Senior Clinicial Admin Coordinator

Optum
02.2019 - Current

Senior Reimbursement Counselor

Lash Group
01.2015 - 02.2019

Patient Coordinator

Lash Group
03.2008 - 01.2015

Associates Degree - Tourism And Hospitality Management

Sawyer School

Similar Profiles

CREATE PROFILE
Jennifer Stouffer