Chelsey Jackson
Cardinal Health
Jacksonville,FL
1
Certification
5
years of professional experience
Customer-focused healthcare contact center professional with 4+ years of experience supporting managed care members, pharmacy benefit services, and patient assistance programs in high-volume remote environments. Skilled in resolving complex inquiries related to insurance eligibility, medication coverage, formulary requirements, prior authorizations, and prescription refills. Proven ability to deliver empathetic, compliant support while maintaining HIPAA standards, accurate CRM documentation, and strong first-call resolution performance. Recognized for improving operational efficiency and ensuring members receive timely access to medications and care.
Work History
Representative II, Customer Care
3 Months- Handled high-volume inbound calls from customers, caregivers, and referral sources regarding medical supply orders and services.
- Provided compassionate and professional customer support while addressing inquiries related to medical supplies, order status, account information, and product availability.
- Recorded customer interactions accurately and maintained detailed records in company systems.
- Collaborated with internal departments to facilitate timely resolution of customer concerns.
- Achieved productivity and quality targets while managing a high-volume call environment.
- Maintained confidentiality of customer and patient information in accordance with HIPAA and company compliance standards.
- Applied active listening, empathy, and problem-solving skills to enhance customer experience.
Customer Care Specialist
5 Months- Managed high-volume inbound and outbound member calls regarding pharmacy orders, prescription coverage, and benefit eligibility.
- Provided Tier 1 pharmacy support including formulary verification, medication coverage guidance, and prior authorization assistance.
- Coordinated prescription processing and medication delivery scheduling while adhering to Board of Pharmacy and accreditation standards.
- Resolved order inquiries, copay questions, and claim-related concerns while maintaining accurate CRM documentation.
- Escalated urgent medication or coverage issues to appropriate clinical or pharmacy teams to prevent delays in treatment.
- Maintained compliance with HIPAA, internal policies, and regulatory requirements.
Contact Center Agent
5 Months- Handled high-volume inbound calls supporting members with pharmacy benefits, insurance eligibility, and medication coverage questions.
- Clearly explained complex health plan policies, benefits, and coverage limitations to ensure member understanding.
- Assisted with prior authorizations, referrals, and prescription refill requests while ensuring timely and accurate documentation.
- Coordinated medication deliveries with pharmacy partners and internal teams to support continuity of care.
- Resolved reimbursement inquiries including copays, claims processing, and coverage determinations.
- Escalated urgent pharmacy issues to clinical teams to prevent treatment delays.
- Maintained strong performance metrics including call efficiency, quality assurance standards, and first-call resolution.
Customer Experience Associate II
2 Years 2 Months- Supported patients enrolled in pharmaceutical assistance programs, including insulin affordability programs.
- Assisted with medication refill requests, prescription processing, and coordination with pharmacies and manufacturer partners.
- Guided patients through eligibility verification, benefits review, and assistance program applications.
- Addressed billing inquiries, copay assistance questions, and claim documentation requirements.
- Maintained strict HIPAA compliance while documenting interactions within CRM systems.
- Collaborated with pharmacy partners to improve refill workflows and medication delivery timelines.
- Contributed to operational improvements that reduced authorization processing time by approximately 30%.
Education
High School Diploma
Skills
Enhanced customer experience by providing exceptional healthcare service support.
Improved efficiency in pharmacy benefits and managed care operations.
Increased accuracy in insurance eligibility and benefits verification.
Streamlined prior authorization processes and improved referral coordination.
Boosted call center productivity through effective management strategies.
Strengthened adherence to HIPAA regulations and compliance standards.
Achieved data accuracy and reliability in CRM documentation.
Improved medication coordination and prescription refill processes.
Resolved claims and coverage issues
enhancing customer satisfaction.
Successfully de-escalated conflicts
maintaining positive customer relations.
Achieved high first call resolution rates through effective problem-solving.
Advanced patient advocacy initiatives
resulting in better-informed members.
Certification
- Certified Nursing Assistant. South Florida Healthcare Institute , Boca Raton Fl , 33431 09/21/2025 - 05/31/2028
- Basic Life Support. South Florida Healthcare Institute , Boca Raton , Fl 33431. 9/6/2025- 9/30/2027
Timeline
Representative II, Customer Care
Cardinal Health
05.2026 - CurrentRead More
Customer Care Specialist
Centene Management
05.2025 - 10.2025Read More
Contact Center Agent
Healthfirst
09.2024 - 02.2025Read More
Customer Experience Associate II
Conduent
11.2021 - 01.2024Read More
Frank H. Peterson Academies
High School Diploma
Read More