Jadelyn Fields Email & Phone Number

• Recruit future talent and internships. Train, develop and supervise employee management. Coach, direct and develop a team of all-star Provider Performance Representatives, including hiring, onboarding, training and.
• Participates and orchestrates development and implementation of systems that support network operations and network management.
• Communicates and advocate providers' needs to internal stakeholders to drive creation of solutions that meet our mutual business goals.
• Collaborates with relevant internal stakeholders to identify obstacles and barriers that impact providers globally and execute methods to mitigate risk and provide effective resolutions.
• Consistently strives to foster trust and cooperation to strengthen partnerships and uphold our commitments, ensuring the integrity of the organizations mission and vision is paramount.
• Analyze data (claim, prior authorization, portal) and review with appropriate departments to ensure accuracy and address concerns. Facilitates claims-based change management performance, anticipating and creating.

• Subject matter expert in revenue cycle management, coding, billing, clams processing, disputes/grievance, prior authorization, and network service systems. Facilitates the exchange of information between these systems.
• Serves as chair member for Provider Relations Improvement. Presents and gathers trends of information, feedback and analysis from various departments to identify opportunities to educate providers and improve provider.
• Primary role is to educate contracted and non-contracted providers regarding appropriate claims submission requirements, coding updates, electronic claims transactions, electronic fund transfers, and other available.
• Overall goal is to improve the provider experience and, ultimately, the member experience.

Phoenix, AZ

Subject matter expert responsible for talent selection, training, mentoring and employee development while responding to complex issues and proficiently completing health-plan and department projects as assigned. Applies National Federal, State and Managed Care Cost Containment policies in claim adjudication and reimbursement processing. Identifies, tracks.

Oversees the daily operations serving multiple Physician Medical Clinics and Hospital Physician Services billing. Responsible for the implementation of current and future strategies to bill insurance, process payments, minimize bad debt, improve cash flow, and manage the company’s insurance and receivables. Responsible for managing day to day activities of.

Licensed Insurance Producer liaison between clients, health insurance providers and the Healthcare Marketplace uncovering solutions in a complex health insurance environment. Counsels clients of the unique individual impacts of the Affordable Healthcare Act, their healthcare benefits and penalties and outline available healthcare benefit plan options, and.

Establishes client on-boarding process; credentialing, software installation, practice management set-up, training, technical and all functional support for new and existing clients. Assists in monitoring and actively working billing and collection activities. Assures proper accounting procedures and controls are in place and followed. Ensures payments for.

Assigned to specialty collection projects such as stop-loss, and potentially uncollectable account reviews. Versatile in project scope with all actions of billing and collecting, having a broad knowledge of Government and Commercial medical insurance payers with a high level of skill set in provider credentialing, contracting and reporting. Takes ownership.

Project Manager/Business ConsultantI served as the lead liaison between the contracted vendor MedReview and AmeriChoice to coordinate and complete implementation of vendor practices for several divisions. Assesses and interprets customer needs and requirements. Facilitates day to day client planning processes ensuring business needs are met. Coordinate and.

Responsible for all collection and clerical support functions including, but not limited to, management and training of staff, documentation review and reporting, private party claim submission via paper and electronic filling for 3 office locations valley wide. Developed and implemented system improvements which supported company growth. Significantly.

Rite-Aid Specialty Pharmacy: Maintain daily workflow of (8) employees; responsible for contacting patients of the specialty pharmacy and complete with them a medication assessment based on the specialty medication the patient has been prescribed (specialty medication meaning- high costs injectables for infusions). Received inbound calls from more than 3400.

Registration Representative Lead – Scottsdale Healthcare: South & North Campus’ Breast Health Facility: Responsible for maintaining flow of front office procedures; patient registration into computer database, obtain any prior authorization or insurance verification required by medical insurance for scheduled procedure(s), scheduled and verified future.