Iesha Thompson
Belmont
Summary
Proficient Case Manager Coordinator with experience in non-clinical care coordination roles. Motivated to maintain Member/patient satisfaction, excelling at managing multifaceted projects in fast-paced environments demanding superior organizational, relationship building, and interpersonal skills. Reliable and driven, with strong time management and prioritization abilities.
Overview
22
22
years of professional experience
Work History
Coordinator Disability Advocate
AmeriHealth Caritas
Charlotte
04.2025 - Current
- Responsible for the preparation of case management files for assigned Plan members who are eligible to receive Supplemental Security Income (SSI) or CSHCS benefits and the creation and maintenance of case management documentation in the CSHCS/SSI database.
- Coordinates with the Manager of the DAP and the UM associates to receive monthly data loads and distribute member data to UM for process of renewals.
- Coordinates and facilitates the CSHCS/SSI conversion application process by working closely with members, providers, Utilization Management (UM), and the local Medicaid office (MC), as needed.
- Coordinates with UM to contact members and/or process mailings to Plan members identified as eligible for renewal in the CSHCS/SSI program.
- Maintains relationship and works with providers to facilitate the exchange of medical documentation regarding specialty treatment received for designated chronic medical conditions.
- Work involves frequent contact with members, medical services, government services, providers. Obtain and verify medical and financial information needed to determine SSI/CSHCS eligibility.
Care coordination for TRICARE Prime Demo beneficiaries (Temp)
CareSource
Dayton
10.2025 - 01.2026
- Assisting beneficiaries, providing guidance during care transitions, and effectively managing various health conditions.
- Provide support for intricate, long-lasting, or end-stage diseases without any additional charges.
- Care coordinators work with members and can be contacted for assistance with care needs, including providing in network providers and resources such as shelter and food banks.
- The TRICARE Prime Demo by CareSource Military & Veterans program provides these services to military families and retirees, offering comprehensive care, including 24/7 nurse advice lines and care coordination.
Case Manager- Reimbursement Specialist (Contract position)
TekSystems/Iqvia
Charlotte
12.2024 - 04.2025
- Diligently verifies insurance coverage, submits claims to insurance companies, and ensures healthcare providers receive proper compensation for their services through precise coding of medical procedures and patient information. They maintain strict compliance with billing regulations and effectively communicate with patients and insurance companies regarding payment specifics.
- Responsible for all inbound and outbound phone calls to patients and providers.
- Responsible for single point of contact communication with providers and patients in a designated geographical area
- Contact insurance companies to perform appropriate benefit investigation(s) and coverage eligibility for client product only
- If applicable, assist with the prior authorizations with specific attention to detail and accuracy with provided information.
- Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
- Provide courteous, friendly, professional, and efficient service to internal and external customers including physicians and patients.
- Update job knowledge by participating in educational opportunities and training activities
- Work efficiently both individually and within a team to accomplish required tasks
- Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures
- Eligibility authorization and enrollment into Patient Assistance Program(s)
- Ability to verify insurance requirements to support current billing processes
- Demonstrate a firm grasp of medical billing processes communicating knowledge to internal and external customers
- Identifying and providing corrective action for medical billing reimbursement support specifically to provider offices
Case Manager Coordinator
CareSource
Dayton
04.2023 - 11.2024
- Verify member eligibility, enrollment status, demographic data and current health / psycho-social needs status. Assist members with non-clinical questions relating to completion of HRA questionnaire. Provide educational material and resources to members utilizing multiple delivery methods which could include telephone, email, member portal, and mail services.
- Accurately complete and maintain documentation and based on answers to the screening, transfer qualified members to the appropriate queue for coordination of care or provide appropriate educational intervention.
- Educate members on wellness programs and appropriately refer to case manager for additional assistance.
- Accurately document information and maintain manual data reports as requested by campaign.
- Refer and assist members to access community services and collaborate continuously with leadership on identification and documentation of updated resources.
- Coordinate intake process for provider referrals and member opt-in self-referrals for disease health coaching program.
- Assist in short and long-term outreach programs to complete specific projects related to outreach to providers and identified special populations.
- Review identified member specific well care or preventative needs (HEDIS Flags).
- Maintain appropriate and accurate documentation of telephone or electronic communication to ensure compliance with all state and federal reporting requirements and quality assurance standards.
Patient Service Representative
University Dental Associates
Charlotte
02.2022 - 01.2023
- Greeted patients and visitors, ensuring a welcoming and professional environment. Scheduled appointments and managed the daily appointment calendar.
- Welcomed patients and visitors with a friendly demeanor, ensuring they felt valued and comfortable.
- Communicated courteously, clearly, and calmly with patients in person and over the phone.
- Gathered, verified, and accurately entered updates to dental, medical, and insurance information.
- Answered and responded to telephone inquiries with professionalism.
- Confirmed next-day appointments via phone, providing reminders of patient account statuses.
- Performed various office duties as assigned by the Office Manager.
- Responded to patient billing and financial inquiries, providing appropriate resolutions.
- Collected and posted payments, maintaining accurate records of receipts.
Member Service Representative
Carolina Complete Health Network, Inc
Charlotte
04.2021 - 02.2022
- Referenced current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters. Provided assistance to members and/or providers regarding website registration and navigation.
- Educated members and/or providers on health plan initiatives. Provided first call resolution working with appropriate internal/external resources and ensured closure of all inquiries.
- Documented all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application.
- Processed written customer correspondence and provide the appropriate level of follow-up in a timely manner.
- Researched and identified processing inaccuracies in claim payments and route to the appropriate team for claim adjustment.
- Identified trends related to member and/or provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards.
- Worked with other departments on cross functional tasks and projects.
- Maintained performance and quality standards based on established call center metrics including turnaround times.
Member Service Representative
TTEC - UNITED HEALTHCARE
Concord
11.2020 - 03.2021
- Assisted customers on products/services to provide the best solutions for their health and financial wellbeing. Maintained customer accounts by updating account information. Opened customer accounts by recording account information. Resolved any customer technical issues.
- Obtained information from the customers to make appropriate recommendations for new products and services.
- Increased client retention ration by resolving customer’s complaints while successfully identifying problems and taking appropriate corrective actions.
Waitress/Cafe Associate
The Pines at Davidson
Davidson
09.2004 - 03.2020
- Performed a variety of services including waiting on assigned tables, taking orders, setting and busing tables Attended and participated in in-service training programs Attended and participated in cross training programs with Dietary Aids for secondary job responsibilities.
- Maintained a quality level of services Attended meetings as necessary Followed all safety policies and procedures of The Pines at Davidson and regulatory authorities.
- Addressed any concerns or complaints quickly to improve service and escalated more advanced issues to management for resolution.
- Stocked server areas with supplies before, during and after shifts to boost performance of serving staff.
Education
High school diploma -
North Mecklenburg High School
Huntersville, NCSkills
- Data conversion
- Windows
- Data entry
- HIPAA
- Phone etiquette
- Data analysis skills
- Data verification
- Microsoft Excel
- Communication skills
- Organizational skills
- Salesforce
- Microsoft Outlook
- Data sorting
- Health information management
- Data duplication
- Data filtering
- Microsoft Access
- Typing
Personal Information
Willing To Relocate: Texas
Timeline
Care coordination for TRICARE Prime Demo beneficiaries (Temp)
CareSource
10.2025 - 01.2026
Coordinator Disability Advocate
AmeriHealth Caritas
04.2025 - Current
Case Manager- Reimbursement Specialist (Contract position)
TekSystems/Iqvia
12.2024 - 04.2025
Case Manager Coordinator
CareSource
04.2023 - 11.2024
Patient Service Representative
University Dental Associates
02.2022 - 01.2023
Member Service Representative
Carolina Complete Health Network, Inc
04.2021 - 02.2022
Member Service Representative
TTEC - UNITED HEALTHCARE
11.2020 - 03.2021
Waitress/Cafe Associate
The Pines at Davidson
09.2004 - 03.2020
High school diploma -
North Mecklenburg High School