Jessica Morales
Portland,OR
Summary
Results-focused professional with a background in healthcare operations, medical records, and case coordination. Known for accurate documentation, clear communication, and efficient support of inpatient and SNF workflows. Bilingual in Spanish and committed to patient-centered resolution.
Overview
2027
2027
years of professional experience
Work History
Concurrent Review Technichian
Providence Health & Services
Portland, Oregon, OR
12.2019 - Current
- Facilitated inpatient case coordination, medical necessity review, and timely processing for concurrent review nurses and medical directors.
- Reviewed and organized medical records and admission details to support clinical review and accurate case routing.
- Streamlined communication between providers and facilities for time-sensitive inpatient admission authorizations.
- Worked with clinical teams, providers, and facilities to support appropriate member level of care.
- Supported inpatient and skilled nursing authorization workflows by collecting required information for review.
- Arranged peer-to-peer meetings to facilitate discussions about denied inpatient admissions and support resolution. for denied inpatient admissions.
- Tracked and organized admission and discharge reports in Excel for accurate documentation.
- Used Epic, Facets, Microsoft Office, and Excel for case processing and documentation.
Contact Center Representative
Volt Workforce Solutions
Portland, Oregon
08.2018 - 03.2019
- Assisted customers in high-volume contact center with inquiries regarding insurance policies, claims, benefits, and tax-related issues.
- Managed multiple customer interactions simultaneously while ensuring accuracy and delivering professional service.
- Researched account details and addressed routine inquiries while routing complex cases to appropriate departments.
Office Administrator
Pride Staff
Beaverton, Oregon
07.2017 - 08.2018
- Supported daily office operations to keep workplace running smoothly.
- Updated client records and kept data entry and account files accurate.
- Handled accounts payable and accounts receivable processing.
- Answered incoming calls, emails, and customer inquiries with prompt responses.
- Built professional relationships with clients, vendors, and business contacts.
Legal Account Specialist
Providence Health & Services
Portland, Oregon
- Managed high-value and third-party liability patient accounts to ensure timely resolution and payment collection.
- Supported legal team in resolving outstanding medical balances and collecting payment for services rendered, enhancing financial recovery.
- Communicated with patients, attorneys, and representatives on third-party liability claims and large medical balances to facilitate effective resolutions.
- Negotiated settlement arrangements and explored financial assistance options to resolve medical debt.
- Maintained accurate account records while protecting confidential patient and financial information.
Office Assistant
Providence Health & Services
Portland, OR
- Managed record requests with precision and confidentiality, meeting strict deadlines while performing various administrative duties.
- Scanned, organized, and transmitted confidential patient records, facilitating timely legal reviews.
- Supported patient attorneys and legal assistants by managing information requests for high-value accounts, third-party liability, and workers’ compensation matters, ensuring compliance with legal standards.
- Compiled financial data using Excel to create comprehensive reports.
Public Program Specialist
Providence Health & Services
Portland, Oregon
- Guided members to primary care providers, specialists, transportation resources, and other essential healthcare services to support care access.
- Managed appeals and grievances, resolving member concerns promptly to ensure satisfaction and compliance with regulations.
- Assisted Medicare and Medicaid members with benefit inquiries, clarifying coverage details, co-pays, and deductibles to enhance understanding and access.
- Answered incoming provider calls and verified coverage and eligibility details.
- Provided compassionate customer service during member interactions, fostering trust and promoting positive experiences.
Education
GED -
Portland Community College
Portland, ORHealth Care Interpreting Certificate
Portland Community College
Portland, ORSkills
Concurrent review and medical management
Inpatient and SNF coordination
Medical records management
Patient advocacy and resolution
Epic and MyChart proficiency
Health information systems
Workflow optimization
Microsoft Office applications
- Office management and data entry
- Bilingual in Spanish
Timeline
Concurrent Review Technichian
Providence Health & Services
12.2019 - Current
Contact Center Representative
Volt Workforce Solutions
08.2018 - 03.2019
Office Administrator
Pride Staff
07.2017 - 08.2018
Legal Account Specialist
Providence Health & Services
Office Assistant
Providence Health & Services
Public Program Specialist
Providence Health & Services
GED -
Portland Community College
Health Care Interpreting Certificate
Portland Community College