Jessica Jones
Peekskill,NY
Summary
Highly organized and results-driven Project Coordinator with over 10 years of experience in healthcare administration, provider relations, and service coordination. Proven ability to manage data-heavy projects, streamline operational workflows, and ensure compliance with healthcare standards. Strong communicator and dependable team player who thrives in fast-paced environments. Successful at taking on diverse project tasks to meet tight deadlines.
Overview
16
16
years of professional experience
2006
2006
years of post-secondary education
Work History
Project Coordinator
Healthfirst
New York, New York
11.2019 - Current
- Coordinate monthly provider-related projects such as directory cleanup, license/credential validation, and panel size monitoring.
- Coordinated project schedules and timelines to ensure smooth workflow.
- Manage provider payouts by verifying supplier IDs, reconciling data, and ensuring accurate and timely payment processing.
- Analyze large datasets and reports to ensure outreach efforts align with company guidelines and compliance standards.
- Communicate key updates and findings to internal teams, summarizing outreach results and follow-up actions.
- Maintain audit-ready documentation and support cross-departmental collaboration for high-impact initiatives.
Medical Administrator & Member Service Representat
Affinity Health Plan
New York
05.2018 - 12.2018
- Used Microsoft Excel and pivot tables to manage and process member and claim data.
- Supported billing processes by verifying insurance information and payments.
- Coordinated with providers and members to gather medical documentation, authorize services, and process claims.
- Created and updated member records using internal systems and Excel worksheets.
- Handled up to 100 calls per day, providing support on pre-authorizations, procedures, and member concerns.
- Maintained accurate records, demographic updates, and processed complex medical histories.
Provider Customer Service Representative
OrthoNet
Stamford, Connecticut
10.2016 - 05.2018
- Researched and resolved provider inquiries regarding eligibility, claims, payments, and authorizations.
- Assisted customers with inquiries regarding healthcare services and provider options.
- Handled up to 100 calls per day, ensuring excellent provider satisfaction and timely issue resolution.
- Guided providers through claim submissions and authorization processes with clear communication.
- Completed documentation to track trends in provider issues and improve service operations.
Customer Service Dispatcher
First Transit
Long Island City, NY
06.2009 - 08.2016
- Managed over 150 calls daily to schedule, coordinate, and confirm customer trips.
- Assisted customers with inquiries and ensured timely resolution of issues.
- Produced weekly action lists and reports while incorporating supervisor feedback.
- Supported daily operations and completed special tasks as assigned by leadership.
Education
Park West High School
New York, NYSkills
- Project Coordination
- Data Analysis & Reporting
- Provider Outreach & Compliance
- Microsoft Excel (including Pivot Tables, Vlookup)
- Customer & Member Support
- Healthcare Claims & Authorizations
- Internal Systems (PEGA, PITS)
- Strong Written & Verbal Communication
Timeline
Project Coordinator
Healthfirst
11.2019 - Current
Medical Administrator & Member Service Representat
Affinity Health Plan
05.2018 - 12.2018
Provider Customer Service Representative
OrthoNet
10.2016 - 05.2018
Customer Service Dispatcher
First Transit
06.2009 - 08.2016
Park West High School