Jessica Larner
Melbourne,FL
Summary
Driven healthcare professional with over 10 years of customer and patient care experience. Skilled in assessing the healthcare related needs of the individual, as well as meeting business goals and metrics. I excel at generating solutions, and applying forward thinking techniques to difficult situations. I hope to share these skills with your organization.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Clinical Support Specialist
Health First Health Plans
11.2023 - Current
- Analyze data pertaining to inpatient discharges, creating the appropriate referral for the clinical team.
- Initiated follow up calls to check on the status of members after discharge from a hospital or skilled nursing facility.
- Make up to 20 outbound calls a day to insured members to conduct Transitions of Care assessments.
- Directly enroll and manage members in the Pre-diabetes case management program; communicating monthly with members about educational material related to weight, diet, and exercise.
- Monitor progress of enrolled members by tracking height, weight, and BMI data monthly.
- Refer members to social work, Complex Case, and the Integrated Care Program, based on careful evaluation of their post-discharge needs.
Customer Care Associate
Health First Health Plans
03.2023 - 11.2023
- Investigate complicated claims issues, offering the appropriate solution/information to the caller.
- Create document supply requests and route to the appropriate department for member/provider delivery.
- Compile information to compose grievances for members over the phone.
- Review and utilize multiple Excel spreadsheets for up to date provider information, check cashing statistics, wellness program inquiries, etc.
- Display empathy and compassion daily, while actively listening to and addressing member concerns.
- Recorded detailed notes of all customer interactions in an internal call logging system.
- De-escalated calls from distraught members on multiple occasions, preventing a transfer to leadership.
- Volunteer for and attend multiple activities outside of assigned daily duties, such as member benefit sessions, broker seminars, and Medicare member events.
Medical Receptionist
Coastal Mental Health Center
04.2019 - 01.2021
- Verified insurance coverage for appointments and collected co-payments as required.
- Scheduled patient appointments, verifying accuracy of appointment times with providers.
- Compiled and submitted prior authorization requests to up to 15 different insurance companies.
- Regularly review provider licensing and ensure they are renewed and displayed before expiration date.
- Composed monthly schedules based on availability and patient needs for multiple therapists across the organization.
- Adhered to strict HIPAA guidelines regarding patient information.
Customer Service Lead
Winn Dixie
02.2013 - 04.2019
- Directed customer service staff activities, including training, coaching and performance management.
- Maintained accurate records of customer interactions and transactions.
- Resolved escalated issues from team members or customers in an efficient manner.
- Accounted for up to 20 cash drawers at a time, reconciling discrepancies as needed,
- Performed daily cash management activities including posting payments, transfers, deposits, and withdrawals.
- Conducted domestic and international wire transfers using third party software.
Education
MBA - Healthcare Management
Florida Institute of Technology
Melbourne, FL12.2025
Bachelor of Science - Healthcare Management
Eastern Florida State College
Cocoa, FL12.2019
Skills
- Documentation and Reporting
- Time Management
- Problem solving
- De-escalation
Certification
- HIPAA Basics Training Department of Children and Families - 2019
- Functional Assessment Rating Scale Department of Children and Families - 2019
- Scientific Workplace Preparation Certificate Eastern Florida State College - 2017
Timeline
Clinical Support Specialist
Health First Health Plans
11.2023 - Current
Customer Care Associate
Health First Health Plans
03.2023 - 11.2023
Medical Receptionist
Coastal Mental Health Center
04.2019 - 01.2021
Customer Service Lead
Winn Dixie
02.2013 - 04.2019
MBA - Healthcare Management
Florida Institute of Technology
Bachelor of Science - Healthcare Management
Eastern Florida State College
- HIPAA Basics Training Department of Children and Families - 2019
- Functional Assessment Rating Scale Department of Children and Families - 2019
- Scientific Workplace Preparation Certificate Eastern Florida State College - 2017
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