Anneka Jackson
South Holland,IL
Summary
I am seeking a career opportunity that will allow me to utilize my education, skills and experience in a professional healthcare setting where I can obtain upward mobility within the company and the medical field.
Overview
14
14
years of professional experience
1
1
Certification
Work History
workfore Absence team lead
Sedgwick
12.2019 - Current
- Supervises multiple teams of examiners and/or several technical operations colleagues for a wide span of control; may delegate some duties to others within the unit
- Provides technical/jurisdictional direction to examiner reports on claims adjudication
- Compiles, reviews, and analyzes management reports and takes appropriate action
- Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards
- Acts as second level of appeal for client and claimant issues regarding claim specific, procedural or special requests; implements final disposition of the appeal
- Reviews reserve amounts on high cost claims and claims over the authority of the individual examiner
- Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client
- Maintains contact with the client on claims and promotes a professional client relationship; makes recommendations to client as suggested by the claim status; and provides written resumes of specific claims as requested by client
- Assures that direct reports are properly licensed in the jurisdictions serviced
- Ensures claims files are coded correctly and adequate documentation is made by claims examiners.
- Administers company personnel policies in all areas and follows company staffing standards and training recommendations
- Interviews, hires, and establishes colleague performance development plans; conducts colleague performance discussions
- Provides support, guidance, leadership and motivation to promote maximum performa
Heath Care Insurance Agent
Go Health Insurance
07.2017 - 03.2019
- Handling inbound and outbound sales inquiries to sell health insurance plans and products via phone to customers and product offerings, including Major Medical, Medicare Advantage, Medicare Supplement, Prescription Drug Plans, and other ancillary health products
- While staying in compliance with Comply with Federal CMS and State legal requirements and standards.
Reimbursement Specialist
Walgreens Medical Supply
08.2014 - 01.2017
- Cash Posting, Accounts Receivable, Billing & Collections, Accurate submission of invoices to responsible payer, of any type
Gaming Dealer
Horseshoe Casino
02.2010 - 03.2014
- Dealt games, paid out winnings & exchanged currency, Ensured protection of the game; maintained continuous inspection of cards, Ensured betting in compliance with gate rules and minimums set., Implemented customer service policies to players
Education
Associate in science, liberal arts, nursing -
City Colleges of Chicago-Olive-Harvey College
Chicago, IL12.2017
Skills
- Microsoft Office (10 years)
- Billing (3 years)
- Customer Service
- Over ten years of Customer service experience
- Strong computer skills- Microsoft Office & operating systems as well as Outlook
- Very good communication skills, both verbally and written
- ICD-9-CM, CPT coding and Medical Reimbursement knowledge
- Possess proficiency in Medical Practice Management Software Systems
Certification
Health Care Benefits agent, 07/01/17, 07/01/19, national producer #18495168
Career Field
Health Care Career Field
Work Authorization
Authorized to work in the US for any employer
Personal Information
Willing To Relocate: Anywhere
Timeline
workfore Absence team lead
Sedgwick
12.2019 - Current
Heath Care Insurance Agent
Go Health Insurance
07.2017 - 03.2019
Reimbursement Specialist
Walgreens Medical Supply
08.2014 - 01.2017
Gaming Dealer
Horseshoe Casino
02.2010 - 03.2014
Associate in science, liberal arts, nursing -
City Colleges of Chicago-Olive-Harvey College