Summary
Overview
Work History
Education
Skills
Timeline
Generic

ELISHA JACKS

San Antonio,TX

Summary

I am an accomplished Healthcare service professional with a strong track record in conflict resolution, de-escalation and navigating complex benefit structures to ensure member satisfaction. With 10+ years in customer service, I’ve learned great service goes beyond solving problems. It’s about understanding members' needs and making them feel heard, valued, and confident in the support they receive.

Overview

5
5
years of professional experience

Work History

Inbound contact represetntative 3

Humana
San Antonio, TX
04.2023 - 08.2026
  • Handled diverse calls including escalations, claims, pharmacy claims, benefit information, and unresolved issues to ensure customer satisfaction.
  • Collaborated with supervisors and team leads to deescalate challenging calls and resolve complex situations effectively.
  • Maintained performance in a fast-paced environment, utilizing multitasking and time management skills to efficiently navigate multiple screens and systems.

Member Services Team Member

Aetna/ CVS Health
San Antonio, Texas
07.2021 - 01.2023
  • My role as a member services representative was to provide empathetic member service by answering complex plan and benefit inquiries, managed a high volume of calls regarding claims, provider/pharmacy questions, and give support to our members while navigating their plan.
  • Streamlined call resolution processes by multitasking across various systems to enhance member support.
  • Always advocate for my members and go the extra mile to make sure they have the best experience while in my care.

Education

High School Diploma -

Milton B Lee Academy of Science And Engineering
San Antonio, TX
06-2012

Skills

  • Advanced Escalation Resolution: Expert in utilizing empathy and active listening to de-escalate high-tension, sensitive interactions with frustrated members
  • Collaborative Leadership: Adept at partnering within peer supervisor teams to align operational goals and streamline frontline workflows
  • Tier-3 Problem Solving: Excel at diagnosing and resolving complex, systemic account discrepancies, billing issues, and claims disputes
  • Healthcare Subject Matter Expertise: Comprehensive understanding of healthcare benefits, provider services, claims, and Medicare/Medicaid regulations
  • Clear & Empathetic Communication: Fluent in English with a strong ability to translate complicated insurance terminology into clear understanding for all

Timeline

Inbound contact represetntative 3

Humana
04.2023 - 08.2026

Member Services Team Member

Aetna/ CVS Health
07.2021 - 01.2023

High School Diploma -

Milton B Lee Academy of Science And Engineering
ELISHA JACKS