Lorenza Jolivette
Houston
Summary
Experienced healthcare professional with over a decade of expertise in provider relations, appeals, and patient access. Proven track record in coordinating provider communications, resolving claims and grievances, and ensuring regulatory compliance. Adept at serving as a liaison between providers and payers, delivering exceptional support, and enhancing workflow processes across healthcare teams. Skilled in building trusted relationships, handling escalated concerns, and promoting service excellence.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Medicare Appeals and Grievance Specialist II
Centene Corporation
Houston
02.2019 - Current
- Acted as a liaison and advocate for members and providers during the appeals and grievances process.
- Ensured compliance with Medicare regulatory requirements and internal SLA timelines.
- Reviewed provider complaints, researched root causes, and responded with clear, compliant resolution letters.
- Maintained accurate documentation and communication logs for compliance audits.
- Supported provider-facing performance initiatives through data gathering, research, and reporting.
- Handled high-volume document processing to ensure timely resolution of provider issues.
Team Leader, Disability Client Services
MedData Inc.
The Woodlands
11.2017 - 02.2019
- Managed relationships with hospital staff, case managers, and providers.
- Collaborated with agencies and providers to obtain accurate and timely documentation for SSI/SSDI claims.
- Directed staff performance reviews, provided training, and ensured compliance with documentation standards.
- Assisted in resolving complex provider and patient concerns through collaborative solutions.
- Participated in community outreach events aimed at promoting awareness about disability services offered by the agency.
- Developed strategies for improving services to clients in order to meet their changing needs.
- Conducted regular assessments of clients' abilities, skills and goals.
Patient Relations Liaison
Memorial University Medical Center
Houston
12.2015 - 10.2017
- Acted as a communication bridge between patients, providers, and hospital administration.
- Resolved escalated grievances from providers and patients, documenting outcomes in incident reports.
- Provided financial guidance and collaborated with providers to align billing and eligibility requirements.
- Acted as a communication bridge between patients, providers, and hospital administration.
- Resolved escalated grievances from providers and patients, documenting outcomes in incident reports.
- Provided financial guidance and collaborated with providers to align billing and eligibility requirements.
- Ensured compliance with relevant legislation when carrying out liaison activities.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Worked closely with human resources to support employee management and organizational planning.
Patient Access Coordinator
Memorial University Medical Center
Houston
10.2012 - 12.2015
- Verified insurance eligibility, obtained pre-authorizations, and confirmed coverage prior to procedures.
- Communicated regularly with providers and payers to facilitate timely scheduling and billing.
- Coordinated provider communications related to claims status, documentation, and authorizations.
- Educated patients and providers on financial policies and alternative reimbursement options.
- Processed referrals from primary care physicians and other healthcare providers.
- Reviewed medical documents for accuracy prior to submission for billing purposes.
- Coordinated with clinical staff to ensure timely completion of registration process.
- Answered incoming calls, responded to inquiries, resolved customer complaints and provided assistance as needed.
- Audited accounts receivable balances for assigned accounts regularly.
- Participated in training sessions related to new software programs or changes in policies and procedures.
Patient Access Coordinator
Md Anderson Medical Cancer Center
Houston
06.2006 - 10.2012
- Scheduled diagnostic procedures and coordinated closely with providers for accurate appointment mapping.
- Delivered clear and timely appointment preparation instructions to patients.
- Supported seamless provider-patient interaction by minimizing delays and improving schedule flow.
- Answered incoming calls, responded to inquiries, resolved customer complaints and provided assistance as needed.
- Collaborated with other departments within the organization to ensure seamless transition of patients through their healthcare journey.
- Guided patients through the completion of consent and other required medical forms.
- Implemented patient satisfaction surveys to identify areas for improvement.
Education
Bachelor of Science - Business Administration
University of Phoenix
Tempe, AZ08-2007
High School Diploma -
BREAUX BRIDGE SENIOR HIGH
Breaux Bridge, LA05-1987
Certification
- Standard First Aid & CPR – American Red Cross
- Centene University Certifications
- PHWU CHC Provider Relations
- Preparing Your Organization for AI Agents
- Product Management: Building a Product Strategy
- Security Awareness Essentials
- UX Writing Fundamentals
- Marketing Traffic Coordination
- Developing a Feedback Mindset
- Time Management: Working from home
- Effective Communication: Strengthening Relationships Module 3
- Writing a Proposal
Timeline
Medicare Appeals and Grievance Specialist II
Centene Corporation
02.2019 - Current
Team Leader, Disability Client Services
MedData Inc.
11.2017 - 02.2019
Patient Relations Liaison
Memorial University Medical Center
12.2015 - 10.2017
Patient Access Coordinator
Memorial University Medical Center
10.2012 - 12.2015
Patient Access Coordinator
Md Anderson Medical Cancer Center
06.2006 - 10.2012
Bachelor of Science - Business Administration
University of Phoenix
High School Diploma -
BREAUX BRIDGE SENIOR HIGH
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