Jeryxzhen Redd Reyes Ponce

I

Advisor / Case Manager Lead / Trainer

ISTA Personnel Solutions

Aug 2023 - Jun 2026 (2 years 11 months)

• Managed skilled care cases, including level-of-care reviews and insurance authorization requests • Handled appeals and denials management for US healthcare members • Trained new hires and audited facility documentation to maintain compliance and accuracy • Led client meetings and coordinated with case managers to maintain cases for Skilled Nursing Facilities around USA.

L

Medical Virtual Assistant – Admin & Clinical

Laracuente Healthcare Associates

Mar 2023 - Dec 2025 (2 years 10 months)

• Provided administrative and clinical support for a US psychiatry practice • Managed insurance verification, credentialing, appointment scheduling, and clinical notes/orders • Served as technical/AI assistant, organizing and optimizing essential clinical processes • Supported team management and workflow planning

O

Appeals & Grievances Deputy Manager / Contact Tracer Team Leader

Optum Global Solutions

Feb 2020 - Mar 2023 (3 years 2 months)

• Led appeals and grievances for Medicare/Medicaid healthcare coverage, ensuring CMS compliance • Managed multiple teams and team leads to deliver member services • Led deliverable reporting and client organizational meetings • Trained and managed COVID-19 contact tracer team

D

Records Retrieval Supervisor – Legal & Medical

Datafied AHM Services

Jun 2017 - Aug 2019 (2 years 3 months)

• Supervised medical records retrieval for litigation support • Provided administrative support to attorneys and clinical staff • Managed order fulfillment, order tracking, and shipping logistics • Handled customer service processes for legal/medical clients

F

Fraud Prevention & Claims Supervisor

Feb 2014 - Apr 2017 (3 years 3 months)

• Supervised financial disputes and credit resolution teams • Investigated fraud cases and coached agents on financial compliance and customer service • Audited customer calls for quality assurance • Reported daily performance insights to clients

J

Collections / Fraud Prevention & Disputes Representative

JP Morgan & Chase Co.

Aug 2012 - Jan 2014 (1 year 6 months)

• Managed inbound/outbound collections calls for mortgage accounts • Filed disputes, investigated fraud, and provided account resolution support • Delivered customer assistance for payments, account closures, and fraud coverage

Jeryxzhen Redd Reyes Ponce

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