Jessica EdmundsonJE
Open to opportunities

Jessica Edmundson

@jessicaedmundson

Experienced healthcare operations professional with a focus on data integrity.

United States
Message

What I'm looking for

I am looking for a role that fosters collaboration, innovation, and professional growth in healthcare operations.

I am a healthcare operations professional with over 11 years of experience in medical coding, revenue cycle optimization, and clinical quality improvement. My expertise lies in reducing denials, driving coding accuracy, and leveraging EMR data systems like EPIC and ECW. I have a proven track record of using SQL, Power BI, and Excel to generate insightful reports that support both population health and financial performance.

Currently pursuing a PhD in Public Health, I have held various roles including Data Quality Analyst and HEDIS Medical Consultant, where I successfully standardized large datasets and developed compliance plans for Medicare and Medicaid programs. My commitment to quality improvement is evident in my ability to achieve high audit accuracy and reduce processing times, ultimately enhancing operational efficiency and patient care.

Experience

Work history, roles, and key accomplishments

N(
Current

Vice President of Communications

National Society of Leadership and Success (NSLS)

Jan 2024 - Present (1 year 6 months)

Lead strategic communication initiatives and oversee chapter-wide messaging across digital platforms, email campaigns, and member engagement materials. Develop and manage content strategies that align with national leadership values, ensuring clarity, consistency, and engagement across internal and external audiences.

NH

Data Quality Analyst - HERRC Project

NYC Health + Hospitals

Feb 2024 - Mar 2025 (1 year 1 month)

Standardized large datasets across emergency housing and health operations. Cleaned and validated records using SQL and Salesforce, reducing report errors by 20%.

HH

HEDIS Medical Consultant

Highmark Health

Oct 2023 - Mar 2024 (5 months)

Developed compliance plans for Medicare Stars and Medicaid programs. Used Power BI to monitor quality gaps, improving documentation compliance.

OG

Quality Analyst - EHR Data Migration

Optum / UnitedHealth Group

Feb 2022 - Oct 2023 (1 year 8 months)

Achieved 98% audit accuracy and reduced review cycle time by 30%. Created SOPs using Smartsheet and led EHR abstraction onboarding.

BS

Medical Coding Analyst

Blue Cross Blue Shield

Jul 2020 - Feb 2022 (1 year 7 months)

Raised coding throughput by 25% and increased revenue by 10%. Ensured 100% audit compliance across risk-adjusted coding projects.

TH

Medical Coding Supervisor

The Floating Hospital

Jun 2019 - Jul 2020 (1 year 1 month)

Reduced claim processing time by 20% and denials by 10%. Led coder training and reduced billing backlog by 30%.

HE

Clinical Care Coordinator

Healthfirst

Sep 2018 - Jun 2019 (9 months)

Improved HEDIS visit compliance by 25% and screenings by 20%. Ensured 99% data accuracy in patient registries and claims systems.

CS

Medical Billing Specialist

CHE Psychological Services

Jan 2017 - Sep 2017 (8 months)

Processed Medicaid, Medicare, and HMO claims with ICD-10/CPT accuracy. Reduced denials and claim rejections through proactive appeals.

CH

Senior ROI Specialist

CIOX Health

Jul 2014 - Jul 2016 (2 years)

Maintained HIPAA compliance and accuracy across medical record requests. Used EPIC to complete chart releases and quality control.

Education

Degrees, certifications, and relevant coursework

CU

Capella University

PhD, Public Health

Currently pursuing a PhD in Public Health, focusing on advanced research and analytical methods in public health. This program enhances expertise in population health, epidemiology, and health policy.

CU

Capella University

MS, Healthcare Administration - Informatics

Completed a Master of Science in Healthcare Administration with a specialization in Informatics. This program provided in-depth knowledge of healthcare systems, data management, and health information technology.

CU

Capella University

BS, Business Management & Leadership

Earned a Bachelor of Science in Business Management & Leadership, developing strong foundational skills in business operations, leadership principles, and organizational management. This degree provided a comprehensive understanding of business strategies and effective team leadership.

Tech stack

Software and tools used professionally

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