Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jimmele Ridley

Houston,TX

Summary

Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.

Overview

10
10
years of professional experience

Work History

Insurance Verification Specialist

Blue Cross Blue Shield of Texas
Houston, TX
10.2021 - 08.2024
  • Performed daily audits of submitted claims to ensure compliance with industry standards and regulations.
  • Maintained accurate documentation on all pre-authorization requests, denials and appeals.
  • Conducted regular audits of patient accounts for accuracy of demographic data.
  • Successfully verified insurance coverage for over 500 patients in a timely manner
  • Resolved complex insurance with accuracy and efficiency.

Patient Transporter

Veterans Hospital
Houston, TX
08.2020 - 07.2024
  • Responded quickly in an emergency situation by calling 911 or activating the code blue team if needed.
  • Operated lift devices such as stair chairs safely and efficiently.
  • Assisted nurses with patient transfers, using proper body mechanics and safety measures.

Insurance Verification Specialist

Novant Health, Inc
, TX
02.2015 - 08.2020
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Conducted regular audits of patient accounts for accuracy of demographic data.
  • Observed strict procedures to protect sensitive patient information, medical records, and payment data.

Education

MBA - Business Administration

Texas Southern University
Houston, TX
12-2014

Bachelor of Arts - Kinesiology

Grambling State University
Grambling, LA
05-2012

Skills

  • Data Entry Software
  • Medicaid knowledge
  • Understanding of medical terms
  • Eligibility Determination
  • Organization & Time Management
  • Customer Service
  • Insurance Authorization
  • HIPPA Compliance
  • Collaboration & Team Work
  • Team Work Oriented

Timeline

Insurance Verification Specialist

Blue Cross Blue Shield of Texas
10.2021 - 08.2024

Patient Transporter

Veterans Hospital
08.2020 - 07.2024

Insurance Verification Specialist

Novant Health, Inc
02.2015 - 08.2020

MBA - Business Administration

Texas Southern University

Bachelor of Arts - Kinesiology

Grambling State University
Jimmele Ridley