Jalice Timberlake
Mesa,AZ
Summary
Dedicated Customer Service Professional with practiced interactive skills to deliver premium customer service to clients. Offering collaborative and adaptive skills to work seamlessly with team members in a fast-paced environment to drive the attainment of collective goals.
Overview
7
7
years of professional experience
Work History
Insurance Verification Specialist
Childrens Hospital-Mn
01.2023 - Current
- Responsible for effective and efficient verification of all patients' benefits before their appointment
- Responsible for answering incoming calls from other providers, recipients, and carrier groups in relation to insurance coverage
- Research eligibility information online with various insurance carriers
- Responsible for acting as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected
- Ensures all patient questions are answered and issues are resolved timely by utilizing the appropriate resources
- Responsible for obtaining all referrals and authorizations for procedures and services, as required
- Other duties as assigned by the Billing Manager
Administrative Assistant/Receptionist/Customer Service
University of Minnesota Physicians-Minneapolis, MN
01.2021 - 12.2023
- Scheduling appointments/Speak with family's
- Referrals/Documentation Review
- Patient Intake
- Inbound calls / outbound calls
- Medical Terminology / Insurance Verification
- Gathering insurance information/ run insurance payments
- Supported daily office operations by managing schedules and maintaining records.
- Improved office efficiency with organized filing systems and timely correspondence.
- Managed calendars for timely scheduling of appointments and meetings.
- Improved document retrieval with efficient filing and archiving systems.
- Supported management by preparing meeting agendas and documenting minutes.
- Managed office communications to enhance information flow and collaboration.
- Improved document organization with thorough file maintenance, archiving outdated records as necessary for efficient retrieval when needed.
- Demonstrated strong multitasking abilities while managing numerous tasks simultaneously under tight deadlines.
- Supported office efficiency by performing clerical tasks such as data entry, photocopying, scanning, and faxing documents.
Claims Representative
Park Nicollet-Saint Louis Park, MN
01.2020 - 01.2022
- Handle all correspondence via mail, email, phone if needed
- Work claims, gather correct information from both parties
- Processing claims, verifying , investigating denials making sure all documentation is correct
- Other duties assigned by management
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Developed in-depth understanding of insurance policies and procedures.
- Conducted detailed investigations into suspicious claims, reducing instances of fraud.
- Achieved high levels of accuracy in claim assessment, minimizing company's exposure to risk.
- Calculated adjustments, premiums and refunds.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Processed and recorded new policies and claims.
- Modified, updated and processed existing policies.
- Collected premiums and issued accurate receipts.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Prior Authorization Specialist
Convergys-Eagan, MN
01.2018 - 01.2020
- Managed a high volume of prior authorization requests for medications, procedures, and durable medical equipment, ensuring timely processing and adherence to insurance guidelines
- Collaborated with healthcare providers, patients, and insurance companies to resolve prior authorization issues and facilitate approvals
- Maintained accurate records of prior authorization requests and processed appeals as needed
- Utilized electronic health records and prior authorization software to streamline the process and track approvals
- Stayed up-to-date on insurance policies, billing codes, and regulatory requirements related to prior authorizations
- Effectively communicated with stakeholders and provided timely updates on the status of requests
Education
High school or equivalent -
Augsburg Fairview Academy
Minneapolis, MN05-2013
Personal Information
- Willing To Relocate: Anywhere
- Authorized To Work: US for any employer
Timeline
Insurance Verification Specialist
Childrens Hospital-Mn
01.2023 - Current
Administrative Assistant/Receptionist/Customer Service
University of Minnesota Physicians-Minneapolis, MN
01.2021 - 12.2023
Claims Representative
Park Nicollet-Saint Louis Park, MN
01.2020 - 01.2022
Prior Authorization Specialist
Convergys-Eagan, MN
01.2018 - 01.2020
High school or equivalent -
Augsburg Fairview Academy
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