Yolanda L Jackson

Experience

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  OhioHealth

  Jun 1998 - Feb 2003

  Patient Registration Representative

  Registered patients for inpatient, outpatient, and emergency procedures.Assisted patients with activities of daily living.

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  Anthem, Inc.

  Nov 2003 - Feb 2005

  Claims Examiner

  Processed electronic and paper claims to include HCFA 1500, and UB 92's.

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  Franklin County

  Dec 2005 - Jun 2006

  Case Manager

  Determined eligibility for consumers for social service programs such as Medicaid, cash assistance, and food stamps.

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  Molina Healthcare

  Jun 2006 - Sept 2010

  Care Specialist

  Processed medical authorizationsCompiled reportsDeveloped workflows

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  The Ohio State University Wexner Medical Center

  Sept 2010 - Oct 2021

  UM Case Manager

  Gathers medical documentation needed for submission to insurance companies for approval of inpatient stays.Applies ICD-9 codes and DRG's to hospital staysUtilized Milliman to determine if patient was inpatient, outpatient, or observation stay appropriate

• 

  Ohio State University Physicians, Inc.

  Oct 2021 - now

  Clinical Project Analyst

  Completes chart reviews including, but not limited to quality and regulatory programs. Utilize clinical applications and all available sources of documentation to perform reviews.Validates reports and performs reliability abstraction of quality measures. Works with both internal and external customers to meet government, payor, and other third party data requirements. Provides educational sessions with physicians and clinic staff on regulatory programs. Works with various value based care programs Show less