Jessica Alex
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
7
7
years of professional experience
Work History
Appeals and Grievances Coordinator
L.A. Care Health Plan
01.2023 - Current
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Remained knowledgeable regarding company policies and procedures and current developments within operational departments.
- Submitted verbal and written notification to members and providers.
- Provided exceptional customer service when interacting with individuals involved in each appeal or grievance situation, demonstrating empathy and professionalism at all times.
Patient Access Specialist
Providence Saint John's Health Center Emergency Room
09.2022 - 01.2023
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations
- Collected and validated patient demographics and insurance information.
- Maintained patient confidentiality by adhering to HIPAA guidelines and hospital policies.
Admissions Coordinator
Fireside Healthcare Center
06.2021 - 09.2022
- Confirmed all insurance benefits met standards of admissions as dictated by policy
- Developed admissions policy, outlining rules and procedures compliant with government regulations
- Placed new supply orders, managed inventory and restocked clerical spaces
- Maintained a high level of customer service with patients, families, and visitors by consistently displaying empathy, professionalism, and excellence in communication skills.
- Collaborated with multidisciplinary team members to ensure seamless coordination of all aspects of patient care from admission to discharge.
Data Entry Coordinator
St. John's Well Child
01.2020 - 06.2021
- Worked through E Clinical Works (ECW) to update information
- Maintained data entry requirements by following data program techniques and procedures
- Compiled and sorted information to prepare source data for computer entry
- Reviewed, corrected, deleted and re-entered data to eliminate duplication of data and maintain data integrity.
HEDIS Field Reviewer
Inland Empire Health Plan
02.2018 - 04.2019
- Conducted quality improvement and customer satisfaction surveys to evaluate patient care
- Retrieved medical data for physicians and patients
- Enhanced the quality of HEDIS measurements through meticulous medical record abstraction and documentation.
- Utilized advanced software tools to maintain organized and accurate documentation of field review findings, supporting effective reporting processes.
Education
Medical Assistant -
Everest College
Gardena, CA05.2012
High School Diploma -
Animo South Los Angeles
Los Angeles, CA06.2010
Skills
- Microsoft Office: Word, Outlook, Power Point, and Excel
- Teamwork and Collaboration
- Policy Knowledge
- Dispute Resolution
- Customer Service , Data Entry
- Written/Verbal Communication Skills
- Multi-Line Telephone
- Type 65 WPM
- Organizational Skills
- Medical Terminology
- Customer Satisfaction
- Organization and Time Management
Timeline
Appeals and Grievances Coordinator
L.A. Care Health Plan
01.2023 - Current
Patient Access Specialist
Providence Saint John's Health Center Emergency Room
09.2022 - 01.2023
Admissions Coordinator
Fireside Healthcare Center
06.2021 - 09.2022
Data Entry Coordinator
St. John's Well Child
01.2020 - 06.2021
HEDIS Field Reviewer
Inland Empire Health Plan
02.2018 - 04.2019
Medical Assistant -
Everest College
High School Diploma -
Animo South Los Angeles
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