Sabrina Saint Jean
Bloomfield,NJ
Summary
Experienced Disability Claims Adjudicator skilled in evaluating applications and analyzing medical data at the New Jersey Department of Labor and Workforce Development. Proficient in processing insurance claims and communicating effectively with claimants to gather necessary information. Former Financial Counselor with expertise in Medicaid eligibility and application coordination, ensuring accurate assessments and positive outcomes for clients
Overview
6
6
years of professional experience
Work History
Disability Claims Adjudicator
New Jersey Department of Labor and Workforce Development
09.2022 - Current
- Conduct comprehensive reviews of long term and short-term disability claims, analyzing complex medical and nonmedical documentation to determine eligibility.
- Coordinate field-based consultative exams and manage claimant scheduling, coordination, and documentation retrieval.
- Communicate with claimants, physicians, and third parties to clarify details and resolve inconsistencies.
- Document case findings thoroughly and make prompt decisions aligned with federal and state regulations.
- Independently manage a high-volume caseload while meeting accuracy and compliance standards.
- Participated in team discussions to streamline processes and improve adjudication consistency.
- Collaborated with peers to resolve complex disability claims, sharing knowledge to improve claim quality and consistency.
- Demonstrated strong customer service by clearly communicating eligibility decisions and addressing claimant concerns.
Financial Counselor
Affiliated Healthcare Management LLC
03.2022 - 09.2022
- Led the Financial Counseling team during daily operations, ensuring adherence to eligibility screening procedures and productivity standards.
- Trained new staff on Medicaid and Charity Care application processes, resulting in improved team efficiency.
- Screened patients for Medicaid and Charity Care eligibility through detailed interviews and financial analysis.
- Managed patient accounts and collaborated with billing departments to resolve insurance-related issues.
Patient Access Representative
Job Haines Nursing Home
05.2021 - 03.2022
- Company Overview: Active Orthopedics (Summit Health)
- Handled patient registration, insurance verification, and HIPAA documentation with accuracy and professionalism.
- Scheduled diagnostic and surgical procedures, ensuring required authorizations were secured.
- Maintained excellent patient service in a high-volume, fast-paced healthcare setting.
- Active Orthopedics (Summit Health)
Certified Nursing Assistant
Mountainside Medical Center
01.2019 - 01.2020
- Provided daily care including bathing, dressing, and feeding elderly patients.
- Monitored vital signs such as blood pressure and blood sugar levels.
Education
Bachelor of Science - Healthcare Administration
Felician University
05.2020
Skills
- Team collaboration
- Conflict resolution
- Medical & Vocational Evidence Analysis
Community Service
- Board Member, Urban Education Project, Vice President
- Student Volunteer, Hackensack Medical Center
Professional Highlights
- Expert Review and Analysis: Reviewed applications thoroughly and analyzed complex medical and nonmedical data to accurately determine disability status for applicants.
- Effective Communication: Initiated and maintained regular communication with claimants to gather essential information, clarify details, and provide updates throughout the claims process.
- Accurate Evaluation: Applied expertise to calculate Substantial Gainful Activity (SGA) levels precisely, ensuring compliance with regulatory standards and guidelines.
Timeline
Disability Claims Adjudicator
New Jersey Department of Labor and Workforce Development
09.2022 - Current
Financial Counselor
Affiliated Healthcare Management LLC
03.2022 - 09.2022
Patient Access Representative
Job Haines Nursing Home
05.2021 - 03.2022
Certified Nursing Assistant
Mountainside Medical Center
01.2019 - 01.2020
Bachelor of Science - Healthcare Administration
Felician University