MARWANDA JONES
Des Moines,Iowa
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
10
10
years of professional experience
Work History
Family Case Management Coordinator
Impact Community Action
01.2023 - 01.2024
- Proficiency in reading, writing and speaking the English language
- Committed to the concept of diversity and the inherent worth of every individual
- Knowledge of the dynamics and issues associated with poverty
- Ability to work alone with minimal oversight and instruction
- Strong and assertive oral and written communication skills
- Strong commitment to achieving results
- Strong communication skills, including listening skills
- Strong ability to think and reason independently, and to make critical judgments within agency and program guidelines
- Utilizes problem-solving skills in all situations, identifying a range of reasonable options and alternatives
- Dedicated to continuous learning
- Knowledge of data collection, analysis, organization, and report preparation
- Demonstrated ability to effectively and efficiently organize staff and other resources to achieve organizational and program strategic outcomes and all deadlines
- Ability to make administrative/procedural decisions and judgments
- Ability to manage multiple priorities
- Must be able to maintain strict confidentiality
- Willingness to work the hours required to meet deadlines and fulfill strategic requirements
- Develops nurturing and supportive work environments
- Demonstrated abilities to work with diverse constituencies
- Pursues professional growth
- Flexible and adaptable to change
- Ability to represent and advocate for the persons served by IMPACT
- Ability to maintain a complex network of relationships
- Strong computer skills
- Must be able to learn and effectively use a variety of computing software, electronic devices, and databases, i.e
- Microsoft Office.
Family Service Specialist
Impact Community Action
01.2021 - 01.2023
- Able to read, write and speak the English language
- Committed to the concept of diversity and the inherent worth of every individual
- Strong commitment to achieving results
- Strong communication skills, including listening skills
- Strong ability to think and reason independently, and to make critical judgments within agency and program guidelines
- Utilizes problem-solving skills in all situations, identifying a range of reasonable options and alternatives
- Dedicated to continuous learning
- Must be able to maintain strict confidentiality
- Intermediate computer skills
- Must be able to learn and effectively use a variety of computing software, electronic devices, and databases, i.e
- Microsoft Office.
Client Intake Specialist
Bidwell Riverside Center
01.2018 - 01.2018
- Greet families with a kind and compassionate demeanor
- Handle all information with tact and discretion, recognizing the confidential nature of Bidwell
- Explain the food pantry process and additional resources to new families
- Connect clients with immediate needs to specific community services
- Maintain participant case records, program data, and other statistical records as needed
- Keep resource information and flyers current (internal as well as community)
- Assess eligibility of families for programs provided at Bidwell Riverside Center
- Perform other duties as needed.
Utilization Management Tech
Amerihealth Caritas
01.2017 - 01.2017
- Responsible for assuring the receipt of high-quality, cost-efficient medical outcomes for those enrollees identified as having the need for inpatient and or outpatient precertification preauthorization
- Interacts with facilities, vendors, providers, and other MDwise staff to facilitate the receipt of information, and or records for prompt review and response
- Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making
Billing Specialist
UnityPoint @ Home
01.2016 - 01.2017
- Monitor A/R reports on a daily basis
- Prepare documents for primary and secondary claim filing
- Identify potential discrepancies in claims payment processing
- Handle inquiries regarding claims/reports
- Work to resolve carrier denials for proper payment of claims
- Share responsibility through timely communication of identified problems to assure proper follow up is completed to expedite claims and ensure proper payment
- Generate and process statements and claims forms in accurate as well as timely manner.
Billing Specialist
Mercy Medical Billing
01.2015 - 01.2016
- Billing to minimize underpayment, denials, and re-bill attempts
- Properly submit claims to primary, secondary and tertiary insurance companies with the appropriate Explanation of benefits (EOB) attachments, if applicable
- Bill claims appropriately completing billing requirements via electronic billing requirements or paper claims including any attachment of required documentation
- Notate accounts with proper activity codes for workflow back to the facilities for review of unclean claims
- Maintain and abides by all billing policies and procedures, objectives, quality assurance programs and safety & compliance standards
- Monitor and report trends in payer rejections to management with examples of rejection responses
- Identify issues or trending and provide suggestions for resolution
- Initiate telephone or letter contact to patients to obtain additional information as needed.
CRS/PBO
Mercy Billing Office
01.2014 - 01.2015
- Taking calls from patients, clinics, and insurance agents
- Help patients with the understanding of their medical statement
- Took payments over the phone and uploaded new insurance
- Help patients with payment plans
- Talk to several insurance companies daily
- Follow the HIPAA guidelines and Assist patients on any questions they may have
- Coded data to produce and submit claims to insurance companies
- Work directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
- Reviewing and appealing unpaid and denied claims
- Verifying patients’ insurance coverage.
Quality Assurance Specialist
Cognizant Insurance
01.2014 - 01.2014
- Performs call monitoring and provides trend data to the site management team
- Uses quality monitoring data management system to compile and track performance
- Monitors email customer contacts
- Participates in customer and client listening programs to identify customer needs and expectations
- Provides actionable data to various internal support groups as need Provides feedback to call center team leaders and managers
- Prepares and analyzes internal and external quality reports for management staff review.
Education
Certificate Human Resource Management - AS Human Services
Des Moines Area Community College
Skills
- Customer Service
- Data Entry
- Work Planning and Prioritization
- Relationship Building
Timeline
Family Case Management Coordinator
Impact Community Action
01.2023 - 01.2024
Family Service Specialist
Impact Community Action
01.2021 - 01.2023
Client Intake Specialist
Bidwell Riverside Center
01.2018 - 01.2018
Utilization Management Tech
Amerihealth Caritas
01.2017 - 01.2017
Billing Specialist
UnityPoint @ Home
01.2016 - 01.2017
Billing Specialist
Mercy Medical Billing
01.2015 - 01.2016
CRS/PBO
Mercy Billing Office
01.2014 - 01.2015
Quality Assurance Specialist
Cognizant Insurance
01.2014 - 01.2014
Certificate Human Resource Management - AS Human Services
Des Moines Area Community College