Danielle Jackson
Pompano Beach,FL
Summary
Efficient professional in insurance claims and policy processing, known for high productivity and the ability to complete tasks with precision. Specialized in analyzing claim details, navigating policy databases, and managing customer communications. Excel in problem-solving, adaptability, and teamwork, leveraging these soft skills to navigate complex situations and achieve positive outcomes.
Overview
18
18
years of professional experience
Work History
Claims Representative
WellCare Centene
Pompano Beach, Florida
07.2013 - Current
- Understood Medicare and Medicaid guidelines to ensure compliance.
- Investigated claim discrepancies and resolved issues to ensure timely payment.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Provided customer service support to healthcare providers, facilitating resolution of denied or disputed claims.
- Processed adjustments and appeals according to company guidelines.
- Researched patient eligibility, coverage information, and benefit levels.
- Clarified authorization requirements with healthcare providers.
Customer Service Representative
U-haul
Margate, Florida
05.2008 - 07.2013
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Assisted customers with reservations and vehicle rentals.
- Guided customers in selecting appropriate moving supplies.
- Coordinated vehicle returns and inspections for quality assurance.
- Educated customers on safe equipment use and handling procedures.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Maintained a clean and organized work environment for safety compliance.
- Collected deposits or payments and arranged for billing.
Education
Deerfield Beach High School
Deerfield Beach, FLSkills
- Claims processing
- Medical billing
- CPT coding
- ICD-10 coding
- Claims adjustment
- Claim investigations
- Healthcare provider communication
- Policy requirements and eligibility
- Insurance regulations
- Data entry accuracy
- Microsoft office
- Computer proficiency
- Attention to detail
- Problem solving
- Critical thinking
- Time management
- Effective communication
- Active listening
- Time management
Timeline
Claims Representative
WellCare Centene
07.2013 - Current
Customer Service Representative
U-haul
05.2008 - 07.2013
Deerfield Beach High School