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Joslin Gooden

Customer Service Representative / Support Specialist

Talent
Greenville, MS 38701Member since August 26, 2026
Clinical Documentation ReviewInsurance Pre-Authorization & Medical NecessityConcurrent and Retrospective ReviewsICD-10 and CPT CodesEMR/EHR Systems: EPIC, GAMMIS, CentralReachHIPAA ComplianceUtilization Review ProcessesHealth Records ManagementQuality Assurance and Data CollectionCase Management and Data AnalysisScheduling, Filing, and Data EntryMicrosoft Office SuiteCustomer Service and Active ListeningResearch and Problem Solving
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Clinical Documentation ReviewInsurance Pre-Authorization & Medical NecessityConcurrent and Retrospective ReviewsICD-10 and CPT CodesEMR/EHR Systems: EPIC, GAMMIS, CentralReach

About

Highly motivated utilization review coordinator with experience in behavioral health, data and documentation accuracy, and Medicaid standards, with proven ability to conduct concurrent and retrospective reviews. Seeking a position where I can leverage my years of experience ensuring documentation compliance and quality healthcare service delivery.

Experience

Registered Behavior Technician - Intellistars ABA Therapy

(2021-04)

  • Collected and recorded precise behavioral data in compliance with HIPAA standards.
  • Collaborated with BCBAs to establish treatment plans and document client progress using EHR systems.
  • Maintained detailed session notes supporting medical necessity and billing compliance.
  • Communicated clinical updates to care teams, guardians, and case managers.

Case Manager - Covenant Youth Empowerment

(2020-05 - 2021-05)

  • Developed and maintained client care plans and ensured documentation met Medicaid and internal audit standards.
  • Evaluated treatment outcomes and documented progress using care management software.
  • Coordinated multidisciplinary services and verified service eligibility with insurance payers.
  • Advocated for mental health services while ensuring compliance with utilization review and documentation protocols.

Outreach Coordinator - Logisticare Circulations

(2015-07 - 2020-02)

  • Verified medical appointments, eligibility, and insurance coverage for Medicaid clients.
  • Documented patient transport needs and coordinated care access with healthcare facilities.
  • Educated providers on transportation service policies and required compliance documentation.
  • Conducted high-volume inbound support with documentation accuracy and customer satisfaction metrics.

Insurance Representative - State Farm

(2013-11 - 2015-05)

  • Created and managed client profiles and files, updated records, and documented communication for audits and verification.
  • Interpreted complex insurance coverage policies and guided clients through claim procedures.
  • Documented and managed denied claims.
  • Delivered high-volume client support and data tracking across multiple policies, developing transferable documentation skills.

Consultation Project - Hearts to Nourish Hope

(2023-05 - 2023-05)

Used education and training in industrial and organizational psychology to analyze and suggest changes to business operations, addressing issues identified by the program director. Helped correct operational issues with product development, workplace environment, finances, and other factors affecting hiring, training and development, motivation, and employee satisfaction. Provided a comprehensive organizational diagnostic summary detailing initial complaints and recommendations for improvement.

Education

B.A. - Psychology - Trevecca Nazarene University (2025-09)

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