Sade Jordan

Monitored over 60 agents across two client-based programs, ensuring adherence to quality standards and client expectations. Conducted client calibrations and presented data-driven insights to improve program performance.

Ensured HCP reimbursement by verifying and obtaining accurate benefits, demonstrating a thorough understanding of Medicaid and Medicare policies. Mentored and coached employees, identifying and implementing program enhancements and operational efficiencies.

Reviewed claims to ensure compliance with payor-specific billing requirements and identified optimal care passages for patients. Verified health insurance eligibility and obtained benefit information, while assisting with medical records requests.

Obtained prior authorizations from payers, ensuring compliance with requirements and maintaining accurate records within the EMR. Processed referrals and submitted medical records to expedite the prior authorization process.

Coached teammates and conducted quality audits to enhance productivity and efficiency. Processed and reviewed prior authorization requests, interpreting medical and pharmacy data for accurate system entry.

Studied Healthcare Administration. Gained knowledge in managing healthcare systems and operations.