Jessica Cortez
Henderson
Summary
Enthusiastic Patient Care Coordinator motivated to work with patients, families and care teams efficiently. Friendly, adaptable, and collaborative professional successful devising satisfying solutions to complex problems.
Overview
7
7
years of professional experience
Work History
Patient Care Coordinator
Mercalis
02.2023 - Current
- Regionally aligned and serve as an expert on all aspects of benefit coordination, and other forms of available support and responsible for handling Healthcare Provider, Patient and Field Reimbursement Agent Specialist interactions
- Serve as an advocate to Patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy
- Establishes relationships, develop trust, and maintain rapport with Healthcare Providers and Patients
- Serves as direct point of contact to Health Care Providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and a Patient
- Explain benefits offered by all Payer types including Private/Commercial and Government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B
- Navigate through payer challenges by asking appropriate questions to obtain the necessary result
- Maintain records in accordance with applicable standards and regulations to the programs/promotions
- Liaison between Program Management, Internal Stakeholders, and Healthcare Providers
- Understand the nature of the disease states of Patients of the Program
- Identify and Report Pharmacovigilance Information as required by our client (i.e., Adverse Events)
- Knowledge of Medical and Pharmacy Insurance Terminology and Reimbursement/Insurance, Healthcare Billing, Physician Office, Health Insurance processing and Benefit Coordination Experience
- Communicated with insurance companies to verify coverage by completing a Benefit of Investigations and obtain prior authorizations/appeals for medical treatments and procedures when needed.
- Review and Submit EOB Medical and Pharmacy Claims for drug/administration services.
- Experience with ICD and CPT Codes.
Chiropractor Assistant
Whole Life Chiropractic
06.2022 - 02.2023
- I perform Laser Therapy on patients, put them on Traction Therapy as well as remove Cupping or Acupuncture Needles off
- Verify patients insurance by calling or going online to check their chiropractic benefits coinsurance or copay for all services provided
- Insert into our system authorizations sent for Veterans and Workers Comp patients in order to come in to the office to receive services
- Verify with Medicaid and Medicare patients eligibility and benefits
- Run payment transactions sent by insurance that are sent via check or virtual card
- Check out patients by scheduling their appointments and charging them the amount they owe for the services they received
- Contact lawyers and insurance companies for Personal Injury cases until the case is closed and paid for
- Fax weekly medical notes for Veterans, Workers Comp and Personal Injury patients that came in for services during that week in order for services to be paid for as well as the Superbill for PI Cases
Receptionist
Professional Roofing Installer LLC
06.2019 - 06.2022
- Answering emails to companies
- Booking hotel rooms for all workers when working out of town
- Signing DocuSign Contracts after analyzing them
- Doing weekly payroll for 14 workers
- Completing the yearly Builders Mutual Insurance Company audits for PRI LLC as well as the monthly payments
- Adding up all receipts/bank statements for the yearly tax return in every category that gets filed
Medical Debt Collector
Professional Recovery Consultants Inc
04.2018 - 07.2019
- Answering inbound calls as well as making outbound calls to collect payment
- Working on two computer screens while being on the phone
- Explain to patients medical devices/services served to them when they would call regarding the bill they received
- Answer patients questions about their medical insurance partially or not covering the costs at all for the bill they would receive
- Collecting payments for medical collection debts for patients that in rare occasions had to be put on a payment plan to pay off balance to be removed from collections as quickly as possible
Education
High School Diploma -
Cordova High School
Cordova, TN05.2014
Skills
- Computer Proficiency
- Communication Skills
- Problem-Solving Abilities
- Multitasking
- Case Management
- Patient Care Coordination
- Customer Service
- HIPAA Protocol Adherence
- Healthcare Documentation
- Medical Record Requests
- Patient Outreach and Follow-up
- Payment Arrangements & Negotiation
- Patient Documentation
Languages
Spanish
Native or Bilingual
Timeline
Patient Care Coordinator
Mercalis
02.2023 - Current
Chiropractor Assistant
Whole Life Chiropractic
06.2022 - 02.2023
Receptionist
Professional Roofing Installer LLC
06.2019 - 06.2022
Medical Debt Collector
Professional Recovery Consultants Inc
04.2018 - 07.2019
High School Diploma -
Cordova High School
Similar Profiles
Alyssa TuckerAlyssa Tucker
Patient Experience Specialist at MercalisPatient Experience Specialist at Mercalis
Dejah BurgosDejah Burgos
Program Supervisor at MercalisProgram Supervisor at Mercalis
Dhymonique AlexanderDhymonique Alexander
Reimbursement Case Manager at MercalisReimbursement Case Manager at Mercalis