Jessica Malloy
Rocky Mount
Summary
Dynamic professional with a proven track record at Conduent Call Center, enhancing regulatory compliance and service delivery through meticulous case documentation and interdepartmental coordination. Expert in claims processing efficiency and patient relationship building, I excel in multitasking and compassionate care. Achieved significant improvements in claim adjudication, ensuring prompt and accurate reimbursements.
Offering solid foundation in healthcare regulations and eagerness to learn and develop within this environment. Brings understanding of Medicaid regulations and ability to quickly adapt to new information and processes. Ready to use and develop skills in data management and client communication in Healthcare role.
Overview
14
14
years of professional experience
1
1
Certification
Work History
HBIC Medicaid Representative
Conduent Call Center
09.2022 - 02.2025
- Ensured accurate and timely documentation of all case files, facilitating smooth audits and regulatory compliance.
- Coordinated effectively with other departments and agencies for seamless delivery of services to Medicaid recipients.
- Conducted thorough reviews of eligibility documentation, maintaining compliance with state and federal guidelines.
- Collaborated with healthcare providers to resolve billing issues, facilitating prompt payment of claims.
Dental Claims Processor
Qualfon USA
04.2019 - 08.2022
- Improved claim processing efficiency by accurately reviewing and analyzing dental claims for payment.
- Fostered positive relationships between insurance providers, dental offices, and patients through clear communication.
- Kept detailed records of processed claims, allowing for easy retrieval if questions arose later down the line.
- Assisted management in developing new procedures to streamline workflows, resulting in reduced turnaround times for claim payments.
- Enhanced provider satisfaction with timely and accurate claim adjudication, ensuring prompt reimbursement.
Health Care Aide
Golden Living
02.2011 - 04.2019
- Assisted with daily living activities, promoting patient independence and overall wellbeing.
- Provided assistance in daily living activities by dressing, grooming, bathing, and toileting patients.
- Assisted patients with dressing, grooming and feeding needs, helping to overcome, and adapt to mobility restrictions.
- Utilized problem-solving skills when faced with unexpected situations or emergencies within the healthcare setting.
- Maintained clean, safe, and well-organized patient environment.
- Reduced patient anxiety through effective communication and active listening skills.
Education
Associate of Applied Science - Register Nurse
Pitt Community College
Winterville, NC06-2027
Skills
- Claims processing
- Multitasking capacity
- Compassionate
- Call center experience
- Reliable team player
- Patient care
- Claims processing efficiency
- Healthcare industry
- Patient relationship building
- Insurance verification proficiency
- Dental coding expertise
- Preparing meals
- Vital signs monitoring
Certification
- Six Sigma Certification
- Salesforce Certified Administrator
- First Aid Certification
- OSHA Certified
- CPR/AED Certification
Timeline
HBIC Medicaid Representative
Conduent Call Center
09.2022 - 02.2025
Dental Claims Processor
Qualfon USA
04.2019 - 08.2022
Health Care Aide
Golden Living
02.2011 - 04.2019
Associate of Applied Science - Register Nurse
Pitt Community College
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