JESSICA MEDYATI
Redondo Beach,CA
Summary
Detail-oriented individual well-known for being disciplined. Pursuing a position where my exceptional skills will be appreciated.
Overview
16
16
years of professional experience
Work History
Contract Operations Administrator
Optum/ UHG
El Segundo, CA
03.2024 - Current
- Coordinated internal resources to resolve customer inquiries promptly.
- Assisted in the development of operational processes and procedures.
- HIPAA Regulations
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
- Updated and maintained databases with current information.
- Documented progress using project management software tools like Smartsheet.
- Worked effectively in team environments to make the workplace more productive.
- Identified needs of customers promptly and efficiently.
- Worked with cross-functional teams to achieve goals.
Optum EPO Plan Representative
Optum
El Segundo, CA
12.2022 - 2023
- Created Reference Guide for team/ department
- Educated customers on the benefits and risks associated with various types of insurance plans.
- Identified, evaluated and addressed customer inquiries regarding insurance coverage.
- Participated in training sessions designed to keep staff up-to-date on current developments in the field.
- Researched and responded to customer complaints about their insurance coverage.
- Collaborated with other departments within the organization to ensure smooth delivery of services to clients.
- Maintained pleasant and cordial attitude, remaining calm when issues arose.
- Engaged customers and provided high level of service by carefully explaining details about documents.
- Responded to customer inquiries and problems to promote great service.
- Provided explanation of benefits to patients upon request.
- Assisted in training new employees
Provider Data Integrity
OPTUM
El Segundo, CA
05.2019 - 2022
- Cal Optima Provider Data Validation; phone calls to provider's office
- IDX data input of provider's site number and locations
- Submissions, Changes, Add, and Terminations of providers on health plans
- Apollo data entry of health plans and providers
- Training new staff members
- Highly organized able to multi-task and accomplish multiple objectives
- Professional demeanor and attentive to detail
- Strong computer skills and exposure to Microsoft Word, Excel, Outlook, Apollo, GEIDX
- Macess
Eligibility Representative
Optum
El Segundo, CA
- Uploaded Provider's on IDX (older software)
- Made sure health plans had Provider's loaded on there
- Called health plans in order to check information was matching
- Received multiple Rewards to achieving goals
Administrative Assistant II/ Marketing Coordinator
Optum
El Segundo, CA
- Answered phone calls, greeted, and scheduled appointments on outlook
- Assisted with purchasing of supplies and processed marketing supply orders on MOD
- Organization
- Invoicing and Expensing on Concur
- Ran Salesforce Audits for AEP Meetings
- Initiated new contacts and cultivated business relationships
- Assist with related events rage from 10-1000
- Assist in training new employees
- Assist in participaing in health fairs, open enrollments (AEP), community-based activities, site-based events, and other field marketing activities/ events
- HIPAA Regulations
- Assists in the monitoring and maintenance of marketing supplies inventory for the assigned region
Customer Representative I
USCB America- Resource Management Solutions
Los Angeles
- Adheres to all company policies and procedures
- Follow instructions and maintains workflow
- Answers and properly responds to in-bound phone calls via call center applications/systems
- Working in a fast-paced environment; can multi-task
- Accurately documents in PC system the proper actions taken on each account
- Maintains compliance with FDCPA, FCRA, and HIPAA laws
- Individually performs various call center activities for major hospital clientele
- Receives and places inbound/outbound telephone
- Took Payments / Payment Plans
Sales Associate
Windsor Department Store
Redondo Beach, CA
- Ensure great customer service by assisting in location, availability and selection of merchandise Maintain store selling floor, fitting rooms, visual displays, presentation and conditions
- Assist in daily store recovery, before, during or after store opening hours
- Promote current sales and promotions to customers, including pricing of merchandise
- Adhere to company policies, procedures, and loss prevention practices
- Complete sales transactions and maintain proper accountability at registers
- Process merchandise returns and exchanges courteously and under company guidelines
- Support all management, visuals, and sales team at all times
Recruiter/Assistant Manager
Aflac Insurance
Culver City, CA
- Pro-actively recruit top talent to meet deliverable timelines
- Build networks to find qualified passive candidates
- Post positions to appropriate Internet sources
- Ability to track, document, screen, and disposition qualified candidates
- Use social and professional networking sites to identify and source candidates
- Located and documented where to find ideal candidates
Sales Associate
Smart & Final Extra
Lawndale, CA
09.2011 - 04.2013
- Provided top-quality customer service in accordance with our Company's customer service standards and policies and procedures
- Performed price checks when asked by cashier to verify grocery prices
Office Assistant
A&A Security Services
Hawthorne, CA
05.2008 - 08.2008
- Promptly and courteously answering phones and directing calls as appropriate
- Greeting applicants who come into the office
- Coordinating interviews and schedules of applicants
- Assisting employees with questions and helping to resolve their concerns or identifying the appropriate resources to direct them to
- Assisting with various light admin projects and filing
- Inputting and completing data entry tasks
- Assisting management staff with various administrative functions
Education
Medical Billing Diploma -
American Career College
Long Beach, CA09.2017
High School Diploma -
Da Vinci Design Charter High School
Hawthorne, CASkills
- QuickBooks
- Icollect
- Customer Service/ Jaber
- UB-04 and CMS-1500 Forms
- Data Entry
- Medi-soft
- Scheduling Appointments
- Provider Relations
- Understanding of EOB's
- Type 40 WPM
- Medical Records
- Alight Access
- Medicare and Medi-Cal
- HIPAA Certified
- Smartsheet
- Macess/ GEIDX
- ICD-9, ICD-10, CPT, HCPCS Coding
- Medical Billing
- Filling (Alpha Numeric), Photocopying, Scanning
- Recruitment Software
- Salesforce/ Apollo
- Medical Terminology
- Sales
- Microsoft Office
- Office Ally
- Agility
- EPIC
- Healthcare Claims
- IDXTerm
- 13 Health Plans
- Concur
Accomplishments
- Class Ambassador
- Maintained 3.5 GPA or higher throughout the program
- Incentive for getting a purchase of $500 at Windsor on customer order
- Rewarded for doing over 100 a day (multiple times) in loading provider in IDX with Eligibility team
- Received Employee of the Month
- Received Recognition with the Optum EPO Plan
Volunteer Experience
- Hawthorne Police Department, June 2014, October 2014
- Summer School-Kindergarten, 2008
Externship
Insight Practice Partners, 9601 S Sepulveda Blvd, Los Angeles, CA, 90045- April 2017 to May 2017
Handled accounts
Icollect software to input notes regarding each patient for each account
Used Agility software to get into patient information
Rebilled claims to carriers or patients
Phone calls to insurance companies to get a claim status and insurance websites
Dr. Steven Swaleson MD, 20911 Earl St. #320, Torrance, CA, 90503- March 2017 to April 2017
Knowledge of Office Ally
Checking claim status and billing to right insurance companies
Making phone calls to Insurance companies regarding patients claim status
Mailing claims out with EOBs to Insurances/ claim departments
Updating Claim ICD 10 codes on claims and re-submitting.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Contract Operations Administrator
Optum/ UHG
03.2024 - Current
Optum EPO Plan Representative
Optum
12.2022 - 2023
Provider Data Integrity
OPTUM
05.2019 - 2022
Sales Associate
Smart & Final Extra
09.2011 - 04.2013
Office Assistant
A&A Security Services
05.2008 - 08.2008
Eligibility Representative
Optum
Administrative Assistant II/ Marketing Coordinator
Optum
Customer Representative I
USCB America- Resource Management Solutions
Sales Associate
Windsor Department Store
Recruiter/Assistant Manager
Aflac Insurance
Medical Billing Diploma -
American Career College
High School Diploma -
Da Vinci Design Charter High School