Amirah Jackson
Orlando,FL
Summary
Healthcare and specialty pharmacy professional with 2+ years of experience supporting medication access, insurance verification, benefits investigation, prior authorization, claims processing, and patient/member support. Experienced in coordinating with providers, pharmacies, and payers to resolve coverage issues and facilitate prescription fulfillment. Skilled in HIPAA-compliant documentation, benefits verification, case management, and working high-volume environments while meeting service-level and quality expectations.
Overview
1
1
Certification
8
8
years of professional experience
Work History
Case Manager
AssistRx
Maitland, FL
09.2025 - Current
- Managed a high-volume caseload while serving as the primary point of contact for patients, providers, insurance carriers, and pharmacies, ensuring timely resolution of complex cases.
- Investigated insurance coverage, eligibility, and benefit information through communication with insurance companies, providers, and patients to ensure accurate documentation and minimize delays.
- Reviewed medical records, physician documentation, and insurance requirements to determine coverage and facilitate timely authorization decisions.
- Collaborated with cross-functional teams to resolve escalated issues and ensure efficient case management.
- Analyzed insurance policies, clinical documentation, and payer guidelines to determine coverage eligibility and resolve reimbursement barriers.
- Communicated with providers, patients, pharmacies, and insurance representatives to gather required documentation and resolve complex cases.
- Identified issues for escalation and coordinated with leadership, clinical teams, and insurance representatives to expedite resolutions and improve case outcomes.
Pharmacy Customer Associate (PCA)
Elevance Health (anthem)
Altamonte Springs, FL
05.2024 - 09.2025
- Acted as the primary point of contact for members, providers, and pharmacy partners, communicated claim status, coverage determinations, benefit information, and next steps with professionalism and empathy.
- Supported members with pharmacy benefits, prescription services, insurance coverage, and claims-related inquiries, ensuring timely and accurate resolutions to enhance customer satisfaction.
- Investigated complex insurance, prescription, and benefit issues by researching account information, reviewing documentation, and coordinating with providers, pharmacies, and internal departments to resolve cases efficiently.
- Analyzed insurance coverage, eligibility, and benefit information to assist members in understanding costs, available resources, and coverage options.
- Maintained detailed and accurate case documentation, ensuring HIPAA compliance while meeting quality, productivity, and service standards.
- Collaborated cross-functionally to identify issues and resolve escalated cases, enhancing overall member experience through effective follow-up and problem resolution.
Store Associate
ALDI
Winter Garden, FL
07.2021 - 04.2024
- Delivered exceptional customer service by resolving customer concerns, answering questions, and handling escalated issues in a professional and timely manner.
- Increased sales by 10% through effective cross-selling and promotion of seasonal merchandise, demonstrating strong communication and customer engagement skills.
- Processed high-volume cash and electronic transactions with 100% accuracy while maintaining attention to detail and safeguarding sensitive payment information.
- Collaborated with store leadership and cross-functional teams to support daily operations and ensure compliance with company policies.
- Maintained accurate inventory records through inventory counts, identified discrepancies, and reported findings to management for resolution.
- Investigated inventory variances and scanning errors, communicated recommendations to enhance accuracy and operational efficiency.
- Followed company policies related to safety, loss prevention, and operational compliance while maintaining accurate documentation and reporting.
Technical Customer Support Specialist
Citizens Property Insurance Corporation
Sunrise, FL
07.2018 - 02.2021
- Provided Tier 1 technical and customer support by troubleshooting account, system access, and policy-related issues via phone and email, ensuring timely issue resolution.
- Diagnosed customer concerns, researched root causes, and guided users through step-by-step solutions while maintaining high customer satisfaction.
- Provided clear technical guidance to customers of varying computer proficiency levels, fostering positive support experiences.
- Managed high call volumes while meeting productivity, quality assurance, and service-level expectations.
- Documented interactions and tracked cases using CRM and internal software systems to maintain accurate customer support records.
- Processed policy updates, underwriting endorsements, and system transactions with accuracy while adhering to company policies and compliance standards.
- Resolved discrepancies in documentation and coordinated with cross-functional teams to enhance case resolution efficiency.
Style Consultant
Target
Sunrise, FL
09.2018 - 11.2020
- Delivered exceptional customer service by resolving guest inquiries and providing personalized solutions, significantly enhancing overall customer satisfaction.
- Analyzed sales trends, inventory levels, and customer shopping patterns to support merchandising decisions and improve inventory management.
- Verified product information, pricing, and inventory accuracy, identifying and resolving discrepancies to uphold operational standards and improve accuracy.
- Collaborated with cross-functional team to ensure accurate product placement and pricing compliance, facilitating timely resolution of issues.
- Utilized digital tools and point-of-sale systems to process transactions, access customer information, and support efficient service delivery.
- Maintained attention to detail while balancing multiple priorities in a fast-paced, customer-focused environment.
Education
Associate of Arts - General Studies
Valencia College
Orlando, FL12-2025
Skills
- Insurance Verification
- Prior Authorization Processing
- Benefits Investigation
- Pharmacy Benefits
- Claims Processing
- Appeals and Denials
- Medication Coordination
- Prescription Data Entry
- Eligibility Verification
- Copay & Financial Assistance
- ICD-10 Coding
- HIPAA Compliance
- OSHA Compliance
- Test Claims
- Provider/Pharmacy Coordination
- SLA/KPI Management
- Specialty Pharmacy operations
- Process Improvement
- Data Entry
- EMR/CRM Systems (Salesforce, NextGen, CPR, EnterpriseRX)
Certification
- Property & Casualty Insurance Producer License (04-40)
- OSHA Certification
- HIPAA Certification
Timeline
Case Manager
AssistRx
09.2025 - Current
Pharmacy Customer Associate (PCA)
Elevance Health (anthem)
05.2024 - 09.2025
Store Associate
ALDI
07.2021 - 04.2024
Style Consultant
Target
09.2018 - 11.2020
Technical Customer Support Specialist
Citizens Property Insurance Corporation
07.2018 - 02.2021
Associate of Arts - General Studies
Valencia College