Ray Jones

Seeking a position in the communications or accounting industry, where I can utilize my communication and data entry skills to expand my professional profile.

Care Coordinator - Horizon BCB - NJ

(2026-01 - 2026-05)

NJ HEDIS

• Close Care Gaps: Conducted targeted outreach to members and providers to schedule overdue screenings, successfully closing HEDIS gaps for chronic conditions.
• Data Abstraction: Reviewed and abstracted clinical data from EHR systems to ensure 100% accuracy in HEDIS reporting and NCQA compliance.
• Provider Liaison: Educated medical offices on HEDIS coding (ICD-10/CPT) and documentation requirements to improve quality scores.
• Audit Readiness: Managed medical record retrieval and validation processes to ensure seamless year-end HEDIS audits.
• Member Advocacy: Coordinated care plans for high-risk members, removing barriers to care and improving overall health outcomes.
• Technical Proficiency: Leveraged Excel and quality management software to track real-time compliance metrics and report progress to leadership.

CSR - Maximus - NJ

(2025-09 - 2026-01)

• Member Assistance: Answered high-volume inquiries regarding healthcare marketplace enrollment and plan benefits.
• Data Entry: Documented all caller interactions and tracked inquiries using computerized CRM systems with high accuracy.
• Case Navigation: Facilitated online applications and referred complex issues to appropriate departments or leadership for resolution.
• Regulatory Compliance: Adhered to strict HIPAA privacy rules and standard operating procedures during every contact.

Customer Care Representative - BetMGM Casino - Jersey City NJ

(2024-10 - 2025-02)

Temp Position Via Robert Half

• Received and assisted calls, chats and emails regarding players' account queries
• Provide accurate information and support to players regarding games, promotions, accounts, and technical issues
• Showed total respect and courteous demeanor throughout all communication.

Credentialing Specialist - Robert Wood Johnson Hospital - Somerset NJ

(2023-10 - 2024-01)

Temp Position Via Robert Half

• Conduct research on updated state and federal regulations and policies
• Responded promptly and professionally to customer inquiries via live chat and email
• Provided resolutions to inquiries regarding sports bets and event
• Release information to requesting agencies and public inquiries when required by law
• Help develop internal credentialing processes

Data Entry Specialist CSR - Optum Behavior Health - Atlanta GA

(2022-03 - 2023-06)

• Review and edit member information for enrollment
• Check and complete orders for additional errors or duplicate information before submitting final request
• Flag records for errors and forward to customer service team
• submit final member benefit request after errors have been resolved

Enrollment Specialist - Stride Health - Atlanta GA

(2021-02 - 2021-06)

Temp

• Review and edit member information for enrollment
• Check and complete orders for additional errors or duplicate information before submitting final request
• Flag records for errors and forward to customer service team
• submit final member benefit request after errors have been resolved
• Enrolled perspective members and families for health care with Stride Health

Core Assembly Transmitter/ Receiver Technician - Power Magnetics - Trenton NJ

(2021-07 - 2021-09)

Temp

• Assembled Transmitters and receivers for commercial use via pick slips
• Checked for quality of finished legs and blocks
• assembled transformers and reactors
• tested for for mistakes through out full production
• Set for shipping

Shipper/ Packer/ Receiver - KSI Imports - South Plainfield NJ

(2020-01 - 2020-03)

Laid off to COVID

• Picked and Packed car parts sold Via RockAuto via pick slip
• Assured materials were not flawed in any way
• processed the parts via Internal software
• Logged all completed orders and fixed any errors notified via customer service
• Received all shipments for in house stock

Material Logistics, Inventory Clerk - Transtar Industries - Newportville PA

(2020-10 - 2021-02)

• Worked with an in-house sales team to improve the processing of customers orders.
• Manage the process of scheduling the repair and maintenance of the organization's vehicles involved in product transport.
• Processed client payments
• Monitored cargo movement processes. Processed expense reports and fuel cards
• Used company software to track product shipments across multiple channels.
• Maintained accounts receivable and generated Aging Reports, trained new and current employees

General studies - Girard college high school (2002 - 2005)

Bachelors of Science - Science & Tech - Capital University Conservatory of music (2009 - 2013)