Summary
Overview
Work History
Education
Skills
Certification
Personal Information
Timeline
Generic

QUENTELLA JONES

Florissant,MO

Summary

22 Years in the Revenue Cycle/Healthcare industry with a strong Client Service Support background with an emphasis on Pre-Authorization, Medical Billing, Quality Assurance, and Patient Accounts. Well organized and knowledgeable. Effortlessly engage customers with good communication skills to boost satisfaction and build loyalty. Knowledgeable Implementation Manager with more than 2 years of experience driving critical technology planning and deployment. Researched approach to assessing installation, maintenance and troubleshooting barriers to determine corrective action. Comprehensive resource for managing implementations throughout lifecycle. Extensive oversight for documentation to streamline setup and preservation processes. Strategic Information Technology Manager skilled in guiding navigation of modern technology. Accustomed to driving efficiency and effectiveness by developing, delivering and supporting strategic plans. Demonstrated skill in translating technical requirements to business solutions. Successful 2-year record of building positive relationships with internal and external stakeholders. Insightful Information Technology Manager with 2 years of IT leadership experience including oversight of infrastructure, application support and security services. Dedicated to customer satisfaction with focused delivery of technical solutions. Proven leader in directing operations, maintenance and support of complex systems. Develops creative business solutions, leveraging diverse methodologies and delivering engineering solutions for leading organizations. Highly adept in request for proposal development, technology needs assessments and staff training. Experienced Information Technology Manager well-versed in infrastructure, security planning and daily operations management. Forward-thinking and strategic leader with 2 years of experience. Recognized for cost-effective system improvements, operational streamlining and positive leadership style.

Overview

23
23
years of professional experience
1
1
Certification

Work History

Associate Implementation Manager, PBM Operations

Express Scripts/Cigna
09.2023 - Current
  • Manage assigned requests, ensuring delivery with respect to overall project timeline and intent, and communicating associated risk and status
  • Support new client implementations through tracking and reporting status and metrics, submitting cases for project setup, and coordinating data and access requests
  • Role is not client facing unless assigned by leadership
  • Assist with scheduling and/or joining internal and external calls to provide ad hoc support as assigned
  • This may include creating and/or displaying meeting presentations, documenting and/or distributing meeting notes to attendees, and other related responsibilities
  • Support team development and effectiveness by engaging with peers and leadership in knowledge sharing, training and special projects
  • Demonstrate Cigna values – including teamwork and enterprise mindset – to support a high performance culture.

Client Account Support Lead Analyst

Express Scripts/Cigna
01.2023 - 09.2023
  • Manage assigned requests, ensuring delivery with respect to the overall project timeline and intent, and communicating associated risk and status
  • Support new client implementations through tracking and reporting status and metrics, submitting cases for project setup, and coordinating data and access requests
  • The role is not client facing unless assigned by leadership
  • Assist with scheduling and/or joining internal and external calls to provide ad hoc support as assigned
  • This may include creating and/or displaying meeting presentations, documenting and/or distributing meeting notes to attendees, and other related responsibilities
  • Support team development and effectiveness by engaging with peers and leadership in knowledge sharing, training and special projects
  • Demonstrate Cigna values – including teamwork and enterprise mindset – to support a high performance culture.

CLIENT SERVICE SUPPORT SPECIALIST

Express Scripts
01.2015 - 01.2023
  • Monitored delegated customer services issues to drive timely and accurate resolutions
  • Answered calls, emails and secure message inquiries to service clients and grow business relationships
  • Partnered with other department representatives to resolve complex customer services inquiries
  • Maintained working knowledge of software, products, and services to competently answer customer inquiries
  • Met established productivity, schedule adherence and quality standards to deliver quality customer services
  • Applied de-escalation techniques when responding to customer in stressful situations.

PRIOR AUTHORIZATION COORDINATOR

Express Scripts
01.2004 - 01.2015
  • Managed correspondence with insurance companies, physicians and patients as required for Department of Defense patients
  • Resolved incoming calls concerning member eligibility, benefits, provider information, monthly premium billing, clinical and pharmacy needs
  • Processed referrals and submitted medical records to insurance carriers to expedite prior authorization processes
  • Prioritized Department of Defense prior authorizations and maintained twenty-four-hour turnaround
  • Processed all incoming written requests within established service levels and standards
  • Managed receipt, sorting, profiling, and assigning of documents and correspondence.
  • Answered phone calls and messages for many physicians' medical facility, scheduling appointments, and handling patient inquiries.

CUSTOMER SERVICE/MEMBER CHOICE CENTER SPECIALIST

Express Scripts
01.2002 - 01.2004
  • Resolved customer inquiries, complaints and issues and used problem solving techniques to provide solutions
  • Processed orders and coordinated delivery schedules to meet customer needs
  • Assisted team members and managers with tasks to maintain productivity and meet project milestones.

Education

Certificate - Emergency Medical Technology

Forest Park Community Collage
St. Louis, Mo.
04.2002

Skills

  • STRONG ANALYTICAL AND PROBLEM-SOLVING SKILLS
  • CUSTOMER SERVICE/CUSTOMER RELATIONS
  • MEMBER ACCOUNT MANAGEMENT
  • EXCELLENT INTERPERSONAL AND ORGANIZATIONAL SKILLS

Certification

CERTIFIED PHARMACY TECHNICIAN

Personal Information

Title: Associate Implementation Manager, PBM Operations

Timeline

Associate Implementation Manager, PBM Operations

Express Scripts/Cigna
09.2023 - Current

Client Account Support Lead Analyst

Express Scripts/Cigna
01.2023 - 09.2023

CLIENT SERVICE SUPPORT SPECIALIST

Express Scripts
01.2015 - 01.2023

PRIOR AUTHORIZATION COORDINATOR

Express Scripts
01.2004 - 01.2015

CUSTOMER SERVICE/MEMBER CHOICE CENTER SPECIALIST

Express Scripts
01.2002 - 01.2004

Certificate - Emergency Medical Technology

Forest Park Community Collage
CERTIFIED PHARMACY TECHNICIAN
QUENTELLA JONES