JESSICA ROBERSON
Saint John,IN
Summary
Quality-driven Department Lead eager to promote gains in quality assurance, team productivity and profitability. Top-notch manager proficient in managing teams, schedules and projects. Excellent communicator and planner ready to bring many years of healthcare experience to new role with room for growth and advancement.
Overview
14
14
years of professional experience
Work History
Prior Authorization Specialist
CCH Health Systems at Keystone Advisors
Matteson, IL
02.2024 - Current
- Ensured compliance with state and federal regulations pertaining to prior authorizations.
- Maintained accurate records of all authorization activities in the database system.
- Facilitated communication between providers, payers and health plans regarding prior authorization processes.
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Collaborated with internal staff members to resolve discrepancies or issues related to prior authorizations.
- Provided guidance to providers regarding the prior authorization process.
- Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation.
- Maintained accurate and up-to-date records of authorization requests and outcomes in electronic health record systems.
- Provided customer service to patients and healthcare providers, answering questions related to prior authorization and insurance coverage.
Lead of Referrals Department
University of Chicago Medicine
Flossmoor, IL
02.2022 - 02.2024
- Working under the supervision of the Director of Ambulatory Services with referrals for the UCM physicians.
- Reduces work que numbers to maintain patients to stay within the organization
- Serves as a link between the doctor’s office, health care plans, physicians and patients
- Handles pre-authorizations and referrals to make sure patients can have their medical tests / treatments.
- Resolved patient complaints or answered patient's questions.
- Partnered with leadership on insights and development to newly hired employees to supply knowledge of various company programs.
- Discussed job performance problems with employees, identifying causes and issues to find solutions.
- Researched and prepared productivity reports required by management or governmental agencies.
- Delegated work to staff, setting priorities and goals.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Implemented departmental policies and standards in conjunction with management to streamline internal processes.
- Recruited and interviewed top candidates with zero turnover for over a year.
Lead Customer Associate
University of Chicago Medicine
Flossmoor, Illinois
11.2017 - 02.2022
- Working under the supervision of Physical Therapists I was responsible for scheduling patients, checking in patients, filing paperwork, answering phones, and the completion of billing reports
- WebPT Super user for new integrated system
- Responsible for training Outpatient therapy staff on updated computer system
- Selected to participate in an RIE to make frontline clerical process more efficient
- Developed standard work flow for Outpatient therapy services
- EPIC Super User for new integrated system
- Helping set up system applications and work flows for therapy integration
- Provided coverage as the Ingalls Wellness administrator
- Assisted gaining insurance approval for cardiac rehab patients.
- Engaged with customers and worked to resolve product and service issues.
- Interacted with customers to provide and process information in response to inquiries, concerns and requests about services and products.
- Maintained high satisfaction score by consistently resolving first-call issues.
- De-escalated customer issues with proven conflict mediation and problem-solving abilities.
Lead Financial Counselor
University of Chicago Medicine
Flossmoor, IL
09.2016 - 11.2017
- Assumed Manger role when current Manager was unavailable and was team lead of OP registration and Urgent Aid.
- Operationalized and helped manage 15 patient service representatives
- Answered clients' questions regarding details of financial plans and strategies and explained data in easy-to-understand terms.
- Offered diversified set of solutions and full scope of investment products and services to meet clients' best interests.
- Helps with deposits, lead meetings, staffing, training, ect
- Also, resolves patient complaints and handles day to day issues in the department
- Responsible for calling patients and setting up payment plans
- Resolving billing questions patients would have
- Also, would help out with registering patients if needed
- Covered for Infusion Department and
- Helped with insurance verifications and scheduling tests.
Physical Therapy Aide
University of Chicago Medicine
Flossmoor, IL
06.2010 - 09.2016
- Working under the supervision of Physical Therapists and maintained office and therapy equipment by cleaning and making minor repairs.
- Preformed ultrasounds, put together hot packs, filed charts, and cleaned equipment.
- Worked as part of team to execute proper care of body mechanics and safety of patient.
- Administered and guided patients through simple range of motion exercises to facilitate flexibility and improved circulation.
- Kept detailed records of patient physical therapy treatments and improvements.
- Documented patient physical therapy treatments and made observations on improvement.
- Treated patients in activities of daily living in supportive and maintenance programs.
Education
B.A. - Health Administration
Governors State University
University Park, IL12.2022
High School Diploma -
Homewood - Flossmoor Highschool
Flossmoor, IL06.2007
MBA - Healthcare Managment
Western Governors University
Salt Lake City, UTSkills
- Proficient In - Excel, Microsoft Word, Power Point, Epic
- Administrative Management
- Project Management
- Reporting
- Staff Development
- Staff Training and Mentoring
- Inclusive Leadership
- Process Improvement
- Team Management and Supervision
- Presentation
- Policy and Procedure Implementation
Affiliations
- NSLS Honor Society Member since 2022
- Upsilon Phi Delta Society Member since 2022
References
References available upon request.
Timeline
Prior Authorization Specialist
CCH Health Systems at Keystone Advisors
02.2024 - Current
Lead of Referrals Department
University of Chicago Medicine
02.2022 - 02.2024
Lead Customer Associate
University of Chicago Medicine
11.2017 - 02.2022
Lead Financial Counselor
University of Chicago Medicine
09.2016 - 11.2017
Physical Therapy Aide
University of Chicago Medicine
06.2010 - 09.2016
B.A. - Health Administration
Governors State University
High School Diploma -
Homewood - Flossmoor Highschool
MBA - Healthcare Managment
Western Governors University
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