Justice Hill
O'Fallon
Summary
Detail-oriented healthcare professional with 6+ years of experience in health insurance operations, customer service, electronic documentation review, and regulatory compliance. Proven ability to manage, validate, and protect sensitive health and personal information in accordance with CMS, HIPAA, and privacy standards. Strong background in medical terminology, call center operations, document processing, and release of information–adjacent workflows. Currently pursuing an Associate Degree in Nursing (ASN), adding clinical knowledge to health information accuracy, integrity, and regulatory compliance.
Overview
7
7
years of professional experience
2018
2018
years of post-secondary education
1
1
Certification
Work History
Medicare Insurance Agent
Humana
O'Fallon
07.2023 - Current
- Review and validate electronic healthcare documentation to ensure correct patient information, accuracy, and completeness
- Manage and process documentation and information requests, ensuring compliance with CMS and HIPAA regulations
- Handle high-volume inbound calls from Medicare members while safeguarding protected health information (PHI)
- Analyze records for discrepancies, missing documentation, and compliance risks; escalate issues appropriately
- Maintain accurate electronic records across multiple systems
- Use Microsoft Outlook, Word, and Excel to track documentation, correspondence, and case activity
- Support quality assurance and regulatory documentation initiatives
Medicare Insurance Agent
UnitedHealthcare
Maryland Heights
04.2019 - 06.2023
- Reviewed, interpreted, and explained beneficiary-facing healthcare documentation for accuracy and regulatory compliance
- Managed requests for plan documentation and information, ensuring timely and compliant delivery
- Maintained and updated electronic records within internal healthcare systems
- Identified documentation inconsistencies and supported fraud, waste, and abuse (FWA) reporting
- Communicated complex healthcare information to patients from diverse educational and socio-economic backgrounds
- Collaborated cross-functionally with operations, compliance, and quality teams
Customer Service Representative
PennyMac
Las Vegas
12.2020 - 07.2021
- Managed high-volume inbound calls related to escrow accounts, mortgage payments, deeds, and account documentation
- Reviewed, processed, and securely distributed sensitive financial and legal documents electronically
- Protected personally identifiable information (PII) in compliance with privacy and data security standards
- Sent, received, logged, and archived documents through secure electronic systems
- Documented account activity accurately to support audits, compliance reviews, and regulatory requirements
- Communicated complex documentation details clearly to customers
Education
Associate of Arts - Nursing
Saint Louis Community College
St. Louis, MO 08.2023 - 02.2026
Ritenour High School
St Louis, MOSkills
- Health Information Management (HIM)
- Release of Information (ROI) Processing
- Electronic Medical Records (EMR/EHR)
- Medical Documentation Review & Accuracy
- HIPAA & CMS Compliance
- Medical Terminology
- Healthcare Customer Service
- Call Center Operations
- Data Entry & Records Validation
- Document Scanning, Indexing & Retrieval
- Audit & Regulatory Tracking
- Microsoft Word, Excel, Outlook
- Remote Work & Information Security
Languages
English
Full Professional
Certification
- Health Insurance License – All 51 States
- Medicare, Medicaid & ACA Certified
- CMS Medicare Compliance Training (Annual)
- Fraud, Waste & Abuse (FWA) Certification
Relevant Coursework & Additional Qualifications
Medical Terminology
Health Assessment
Healthcare Ethics & Documentation
Extensive remote work experience adhering to privacy and information security requirements
Familiar with healthcare documentation lifecycle, audits, and regulatory tracking
Dedicated, secure home office meeting telecommuting requirements
Timeline
Associate of Arts - Nursing
Saint Louis Community College
08.2023 - 02.2026
Medicare Insurance Agent
Humana
07.2023 - Current
Customer Service Representative
PennyMac
12.2020 - 07.2021
Medicare Insurance Agent
UnitedHealthcare
04.2019 - 06.2023
Ritenour High School