Name variants:
Sandy Jones
Contact Information
Workplace
Provider Dispute Resolution Manager
Campbell, CA
Industry
Hospital & Health Care
Colleagues
Work History
Provider Dispute Resolution Manager
6201 San Ignacio Ave, San Jose, CA 95119
from Oct 2018
Pdr and Claims Consultant
Audit all medical claims types and provider disputes for various health plans and MSO / IPA companies.
Reported audit medical claims results on State regulated ICE audit worksheets.
...
Sep 2012 — Oct 2018
Claims Resolution Manager
9275 Sky Park Ct #400, San Diego, CA 92123
Regulatory PDR Audits for contracted healtplans
Manage PDR/ Customer Services/Data Entry Units
Claims, PDR and Customer Services Training
Aug 2006 — Sep 2012
Claims Lead and Quality Assurance Analyst
Trained claims staff in processing all types of claims and claims adjustments.
Ensured adherence to software quality assurance standards. Ensured claims database integrity
timely and ...
Apr 1988 — May 1991
Education
1979 — 1982
1979 — 1982
Occupations
Executive
Manager
Health Specialist
Hospital Care Professional
Counselor
Operations Manager
Health Professional
Health Practitioner
Advisor
Skills
Healthcare
Medicare
Customer Service
Healthcare Information Technology
Process Improvement
Hipaa
Insurance
Strategic Planning
Healthcare Management
Management
Health Insurance
Managed Care
Training
U.s. Health Insurance Portability and Accountability Act
Healthcare Consulting
Leadership
Healthcare Information Technology
FAQs about Sandra Jones
What is the main profession of Sandra Jones?
The expert is a Provider Dispute Resolution Manager.
What jobs is Sandra proficient at at?
Sandra is a professional Executive and Manager jobs.
Where does Sandra Jones currently live?
Sandra currently lives in San Diego, California.
How many companies did Sandra Jones work at?
Sandra Jones worked at five jobs.
Where has Sandra Jones studied?
Sandra studied at the Serra High School from 1979 to 1982.
Are there any special industries Sandra Jones is connected to?
Sandra Jones works in Hospital & Health Care industry.
What are professional skills of Sandra Jones?
Sandra Jones has skills in the following areas: Healthcare, Medicare, Customer Service, Healthcare Information Technology, Process Improvement, Hipaa, Insurance, Strategic Planning, and Healthcare Management.