Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jessica Turner

Lewisville,TX

Summary

Achieved a significant 65% revenue increase at Wellbridge Greater Dallas and other facilities through expert utilization management and quality improvement, maintaining denials under 3%. Skilled in documentation review and fostering interdepartmental collaboration, I excel in driving healthcare operations and mentoring teams for optimal performance

Overview

10
10
years of professional experience

Work History

Director of Utilization Review

Wellbridge Greater Dallas
05.2022 - Current
  • Increase revenue by 65% while maintaining denials less than 3%
  • Provided clinical documentation training to all clinical staff while completing daily audits
  • Coordinate and attend meetings to discuss data and collaboration
  • Assist in appeals and retrospective reviews for RCM claims
  • Mentored junior team members, fostering a collaborative work environment that encouraged professional growth and development.
  • Oversee the recruitment and onboarding of new team members, ensuring they were well-equipped to succeed in their roles within the department.
  • Implemented cost-saving measures without compromising quality of care by closely monitoring the use of resources during the review process.
  • Coordinated efforts between clinical staff, case managers, and insurance companies to ensure efficient communication throughout the review process.

Assistant Director of Utilization Review

Georgetown Behavioral Health Institute
01.2020 - 05.2022
  • Assisted in meetings to report data collection and results
  • Assisted in maintaining less than 3% denial rate
  • Managed a caseload of 40 to ensure success and consistency in utilization review outcomes
  • Successfully completed 120 appeals and retrospective reviews for both inpatient and outpatient admissions retaining over 100k annually
  • Trained all clinical staff on accurate and appropriate clinical documentation to reflect MCG guidelines and Medicare standard
  • Trained new hires for the UM Department, Intake and Business Office in regards to prior authorization and insurance verification

Lead Utilization Review Specialist

NIX Health
01.2015 - 01.2020
  • Increase revenue by maintaining denials less than 3%
  • Streamlined workflows and increased efficiency by implementing new software tools and technology for tracking utilization data.
  • Promoted patient satisfaction through careful attention to individual needs during the review process, addressing concerns promptly and professionally.
  • Evaluated new protocols or interventions for cost-effectiveness and clinical utility, supporting evidence-based decision-making within the organization.
  • Collaborated with interdisciplinary teams to create effective discharge plans that promoted optimal patient outcomes while minimizing hospital readmissions.

Education

Master of Science - Public Health

Jackson State University
Jackson, MS
05.2012

Bachelor of Science - Educational Psychology

Alcorn State Univerisity
Lorman, MS
05.2009

Skills

  • Documentation Review
  • Quality Improvement
  • Healthcare operations
  • Interdepartmental Collaboration
  • Utilization Management
  • HIPAA Compliance
  • Discharge planning coordination

Timeline

Director of Utilization Review

Wellbridge Greater Dallas
05.2022 - Current

Assistant Director of Utilization Review

Georgetown Behavioral Health Institute
01.2020 - 05.2022

Lead Utilization Review Specialist

NIX Health
01.2015 - 01.2020

Master of Science - Public Health

Jackson State University

Bachelor of Science - Educational Psychology

Alcorn State Univerisity

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Jessica Turner