Jennifer Penn
Healthcare Administration
Sharpsburg,GA
Summary
Dynamic Integrated Claims Examiner with a proven track record at Reliance Matrix, excelling in claims management and regulatory compliance. Skilled in analytical problem-solving and effective verbal communication, consistently achieving performance metrics while safeguarding patient confidentiality. Expertise in insurance policy and claims assessment drives successful outcomes in high-pressure environments.
Overview
13
13
years of professional experience
2
2
years of post-secondary education
Work History
Integrated Claims Examiner
Reliance Matrix
Phoenix, AZ
06.2024 - Current
- Investigated and resolved an average of 50–60 claim issues weekly, ensuring 100% compliance with departmental protocols and state regulatory guidelines.
- Interpreted and applied contract provisions to determine eligibility and benefit duration, accurately coding 100+ claims per week with financial, diagnostic, and duration data.
- Collaborated with cross-functional teams (e.g., clinical, HR, and payroll) to facilitate seamless claim transitions and support return-to-work strategies, reducing delays by 20%.
- Managed a portfolio of Performance Guarantee clients, consistently exceeding key performance indicators (KPIs) for accuracy, timeliness, and customer service metrics.
- Maintained strict adherence to HIPAA standards, protecting sensitive health information for over 300+ active claimants while upholding organizational and regulatory confidentiality requirements.
Service Center Representative
Optum
New York, New York
03.2022 - Current
- Handled 60–80 customer inquiries daily via phone, email, and chat, achieving a 95%+ resolution rate within first contact.
- Scheduled and coordinated 200+ client appointments monthly, ensuring data accuracy and timely follow-ups.
- Delivered clear, detailed information on service offerings, eligibility, and coverage, contributing to a 92% customer satisfaction score.
- Partnered with internal departments to resolve escalated issues, reducing average resolution time by 30%.
- Maintained and updated client records with 98% accuracy, ensuring full compliance with HIPAA and internal privacy standards.
Medical Information Associate
PPD
Raleigh, NC
10.2022 - 06.2024
- Delivered accurate technical and medical information to an average of 30–50 healthcare professionals and clients weekly, supporting evidence-based clinical decisions.
- Collected, documented, and reported 100+ adverse events and product complaints monthly, ensuring full compliance with FDA, HIPAA, and client-specific regulatory protocols.
- Analyzed complex medical inquiries and provided timely, compliant responses, maintaining a 98% accuracy rate and contributing to SLA adherence.
- Maintained detailed case records and call logs, upholding 100% confidentiality and aligning with organizational, client, and regulatory audit standards.
Patient Care Coordinator
Tegria- Wilmer Eye Institute
Baltimore, MD
02.2020 - 10.2022
- Scheduled over 200 ophthalmology appointments monthly using EPIC, reducing scheduling errors by 15% and maximizing provider availability.
- Handled 80+ daily inbound/outbound calls via auto-dialer system, achieving a consistent 95%+ customer satisfaction rate.
- Processed insurance claims and collaborated with insurance providers, increasing billing efficiency by 25% and reducing claim rejections by 20%.
Senior Patient Care Coordinator
Walgreens Specialty Pharmacy
Canton, MI
09.2012 - 12.2019
- Coordinated the daily delivery of specialty medications for 300+ patients, achieving 98% on-time delivery and ensuring compliance with safety protocols.
- Provided phone and email support, resolving patient issues promptly and maintaining a 90% customer satisfaction rating.
- Managed patient enrollment, medication tracking, and shipment coordination through the Celgene portal, improving processing efficiency by 20%.
- Led medication monitoring programs to enhance patient adherence, contributing to a 15% improvement in treatment outcomes.
- Oversaw end-to-end shipping logistics for specialty medications, ensuring regulatory compliance and minimizing delivery disruptions.
Education
Master of Science - Healthcare Administration
University of Phoenix
Tempe, AZ 06.2024 - Current
Bachelor of Arts - Psychology
Southern New Hampshire University
Hooksett, NH 05.2022 - 11.2023
Skills
Effective Verbal Communication
Claims Management
Proficient in Microsoft Office Suite
Data Quality Assurance
Regulatory Analysis
Disability Claims Management
Analytical Investigation Skills
Medical Procedure Expertise
Insurance Policy Expertise
Claims Assessment
Skilled in Software Utilization
Client Support
Analytical Problem-Solving
Timeline
Integrated Claims Examiner
Reliance Matrix
06.2024 - Current
Master of Science - Healthcare Administration
University of Phoenix
06.2024 - Current
Medical Information Associate
PPD
10.2022 - 06.2024
Bachelor of Arts - Psychology
Southern New Hampshire University
05.2022 - 11.2023
Service Center Representative
Optum
03.2022 - Current
Patient Care Coordinator
Tegria- Wilmer Eye Institute
02.2020 - 10.2022
Senior Patient Care Coordinator
Walgreens Specialty Pharmacy
09.2012 - 12.2019
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