Chyauila Jackson
Miami
Summary
Experienced healthcare and insurance professional specializing in claims processing, benefits administration, and customer support. Manages complex claims inquiries and supports dispute resolution while maintaining compliant documentation in enterprise systems, including FINEOS. Ensures adherence to HIPAA, STD, FMLA, and internal compliance standards.
Overview
9
9
years of professional experience
Work History
Patient Access Associate
Baptist Health Medical Group
Miami
10.2025 - 01.2026
- Documented patient demographics, insurance details, and encounter data in EHR systems, prioritizing accuracy and completeness.
- Ensured accurate data entry, insurance verification, and HIPAA-compliant documentation to streamline patient access operations.
- Provided professional, empathetic patient interactions while adhering to established workflows and healthcare policies.
- Supported multiple access-related tasks in fast-paced healthcare environment, showcasing adaptability and responsiveness.
Customer Experience Specialist
Unum
Chattanooga
10.2023 - 10.2025
- Delivered high-level customer service and technical support for disability, leave, and benefits-related inquiries across multiple communication channels, ensuring compliance with HIPAA and internal policies.
- De-escalated sensitive or disputed claim situations with professionalism and empathy, providing clear, solution-focused guidance to members.
- Navigated multiple systems simultaneously to resolve member concerns efficiently while meeting accuracy, timeliness, and documentation benchmarks.
- Utilized FINEOS to review, research, and document disability and leave claims, ensuring accurate records to support audits, appeals, and claims dispute resolution.
- Analyzed claim history, documentation, and system data to investigate complex claim issues and escalations, determining appropriate resolutions.
- Maintained detailed and compliant claim documentation aligned with regulatory requirements, internal standards, and quality assurance expectations.
- (Remote)
Benefit Advisor
Unum
Chattanooga
11.2022 - 10.2023
- Managed Short-Term Disability (STD) and FMLA benefit inquiries, ensuring compliance with documentation, processing, and regulatory requirements.
- Documented claim activity, eligibility determinations, and benefit decisions in FINEOS, maintaining detailed records for appeals and compliance reviews.
- Reviewed claim information and supporting documentation to confirm determinations aligned with policy guidelines and regulatory standards.
- Communicated benefit information clearly and professionally to internal and external stakeholders while maintaining confidentiality and audit readiness.
- (Remote)
Team Coordinator
DentaQuest
Doral
01.2019 - 10.2022
- Developed training programs for new hires to enhance policy adherence and accurate claims processing.
- Streamlined operational workflows to enhance efficiency while upholding confidentiality and quality controls.
- Led geographically dispersed team, reinforcing compliance and ensuring documentation accuracy.
Customer Support Associate
DentaQuest
Doral
01.2017 - 01.2019
- Assisted customers with inquiries regarding dental benefits and claims processing.
- Resolved customer issues through effective communication and problem-solving skills.
- Educated clients on policy details and available services effectively.
- Maintained high accuracy rates while ensuring compliance with privacy and confidentiality standards for protected health information.
- Processed dental insurance claims and member inquiries, emphasizing detailed documentation and accuracy to support timely resolutions.
Education
High School Diploma -
Hialeah Miami Lakes High School
Miami, FLSkills
- Claims processing expertise
- Benefits administration proficiency
- Healthcare compliance knowledge
- Data accuracy and integrity
- Risk management
- Dispute resolution
- Process improvement
- Enterprise systems proficiency
- Customer service
- Stakeholder communication
Timeline
Patient Access Associate
Baptist Health Medical Group
10.2025 - 01.2026
Customer Experience Specialist
Unum
10.2023 - 10.2025
Benefit Advisor
Unum
11.2022 - 10.2023
Team Coordinator
DentaQuest
01.2019 - 10.2022
Customer Support Associate
DentaQuest
01.2017 - 01.2019
High School Diploma -
Hialeah Miami Lakes High School