Jessica Jurado
Santa Ana,California
Summary
Results-oriented administrative professional with over 15 years of experience providing clerical and operational support in the Managed Healthcare Industry. Organized and dependable with proven experience juggling multiple projects in a fast-paced environment. Dynamic communicator capable of building professional relationships with individuals at all levels of the organization.
Overview
18
18
years of professional experience
Work History
Utilization Management Assistant
CALOPTIMA
Orange, California
01.2009 - Current
- Provide high-level administrative support, care coordination, and data collection assistance to a team of telephonic nurses, physicians, and other corporate staff
- Liaise with members and appropriate department staff to process intake information, enter data into applicable databases, and assist in the medical authorization process
- Conduct discharge assessment calls in English and Spanish to ensure members' medical needs are met and they received high-quality service
- Serve as departmental Subject Matter Expert and train colleagues on department procedures and use of department software and systems
Workers Compensation Specialist
EPLICA, INC.
San Diego, California
01.2007 - 01.2009
- Organized and coordinated day-to-day insurance issues, produced certificates of insurance upon request, and processed verification of coverage requests and workers' compensation claims
- Assisted in monitoring, evaluating, and coordinating ongoing medical treatment for injured employees to mitigate corporate risk and alleviate costs associated with claims
- Drove claims process through initiative-taking and regular dialogues with adjusters to ensure timely follow-through of action items
- Oversaw the Return-to-Work program, including partnering with third-party administrators to ensure that all claims closed promptly
Education
Associate Degree - Criminal Justice
Santa Ana College
01.2024
Community Intervention Worker -
Chapman University
01.2022
Drug & Alcohol Counselor Certificate -
Health Staff Institute
01.2023
Bachelor's Degree - Human Services
California State University of Fullerton
01.2026
Skills
- Utilization Management
- Recruitment
- Case Management
- Telephonic Interpretation
- Data Collection
- Office Management
- Team Leadership
- Data Entry
- Investigation Techniques
- Administrative Support
- New Hire Training
- Claims Management
Timeline
Utilization Management Assistant
CALOPTIMA
01.2009 - Current
Workers Compensation Specialist
EPLICA, INC.
01.2007 - 01.2009
Associate Degree - Criminal Justice
Santa Ana College
Community Intervention Worker -
Chapman University
Drug & Alcohol Counselor Certificate -
Health Staff Institute
Bachelor's Degree - Human Services
California State University of Fullerton