Je'Questa Crenshaw

Business operations and process improvement professional with 7+ years of progressive experience across state and local government, healthcare, insurance, eligibility, claims, and customer operations. Experienced in supporting complex operational initiatives, analyzing business needs, interpreting policies and requirements, identifying process gaps, and translating information into actionable solutions. Proven ability to independently investigate ambiguous issues, coordinate across stakeholders, manage competing priorities, and drive work from problem identification through resolution.

Strong analytical and communication skills in highly regulated, fast-paced, matrixed environments.

Claims Adjudicator II at STATE OF MINNESOTA (2025-10 – Present)

• Manage complex operational workflows involving claims adjudication, eligibility, documentation, policy requirements, and program compliance within a statewide benefits environment.
• Analyze applications, supporting documentation, system information, and program requirements to identify discrepancies, determine eligibility, and drive cases toward resolution.
• Investigate ambiguous operational issues, identify dependencies and root causes, and determine solutions using policy, system data, documentation, and independent judgment.
• Translate program policies, business rules, and documentation requirements into actionable case decisions and operational outcomes.
• Partner with internal business teams and stakeholders to resolve complex cases, documentation gaps, process issues, and escalations without direct authority.
• Identify recurring process gaps and operational pain points that may require workflow, policy, system, or procedural improvements.
• Balance competing priorities, deadlines, dependencies, and stakeholder expectations while maintaining accuracy and regulatory compliance.

Insurance Representative 2 at STATE OF MINNESOTA (2024-09 – 2025-10)

• Supported state insurance operations by researching complex inquiries, analyzing documentation, and interpreting program requirements.
• Assessed applicant needs and translated complex insurance and program information into clear, actionable guidance.
• Identified documentation, eligibility, and process discrepancies and coordinated escalations for cases requiring additional review.
• Collaborated with internal stakeholders to resolve issues spanning customer service, eligibility, program operations, and administrative processes.
• Managed high-volume workloads while balancing service expectations, accuracy, documentation standards, and changing priorities.

Financial Worker 1 at RAMSEY COUNTY (2024-01 – 2024-09)

• Analyzed financial, income, household, and supporting documentation to determine program eligibility in accordance with policies and regulations.
• Managed cases from initial review through determination, including identifying missing requirements, obtaining verification, documenting findings, and resolving discrepancies.
• Applied analytical judgment to complex eligibility scenarios involving multiple data sources and competing information.
• Coordinated with clients and internal stakeholders to obtain required information and move cases toward timely resolution.
• Maintained accurate case documentation supporting regulatory compliance, quality assurance, and operational consistency.

Call Representative at CITY OF SAINT PAUL (2022-03 – 2023-10)

• Served as a cross-functional resource connecting residents, City staff, departments, and external organizations to appropriate services and solutions.
• Researched complex inquiries using City policies, procedures, departmental resources, and technology platforms to determine appropriate actions.
• Gathered and clarified stakeholder needs, analyzed requests, and translated information into actionable guidance and service solutions.
• Exercised independent judgment to resolve ambiguous inquiries and determine when issues required escalation or coordination with other departments.
• Collaborated across City departments without direct authority to obtain information, resolve issues, and improve the customer experience.
• Used multiple technology platforms to research, document, track, and communicate information while managing high-volume competing priorities.

Patient Engagement Representative at UNITEDHEALTHCARE / GENOA HEALTHCARE (2021-08 – 2022-03)

• Coordinated patient engagement, scheduling, medication-access support, and administrative workflows across healthcare operations.
• Worked across patients, healthcare teams, and operational processes to identify needs and coordinate appropriate services.
• Resolved scheduling and service issues while managing competing priorities and maintaining accurate documentation.

Patient Care Advocate at AMPLIFON HEARING (2019-04 – 2021-07)

• Supported healthcare and insurance operations by reviewing claims, medical bills, legal documentation, and patient records for accuracy and completeness.
• Analyzed documentation to identify missing information, discrepancies, and requirements affecting patient services and insurance-related processes.
• Managed patient scheduling, follow-up, documentation, and service coordination across multiple workflows.
• Utilized Salesforce, CRM platforms, and healthcare systems to research, document, and manage customer and operational information.

Master of Science in Advanced Professional Studies – Franklin University

Master of Science in Health Care Innovation – University of St. Thomas

Bachelor of Science in Business Administration & Management – Stillman College