Erica Jackson-Ross
Marietta,GA
Summary
Dedicated and compassionate with a strong background in healthcare administration and a proven track record of providing exceptional support and service. With a keen attention to detail and a focus on optimizing the patient/customer experience, I excel at communication, coordinating medical services, scheduling appointments, and ensuring seamless communication between healthcare providers and patients. Skilled in managing data records, insurance verification, and resolving patient inquiries with professionalism and empathy. Adept at maintaining a high level of patient satisfaction and streamlining administrative processes to enhance the overall quality of care. Seeking to contribute my expertise to a healthcare team that values patient-centric care and operational efficiency.
Overview
3
3
years of professional experience
Work History
Customer Service Representative
Progressive
04.2023 - 11.2023
- Maintained customer satisfaction by addressing customer inquiries and insurance policy needs courteously and professionally
- Actively listened to customers, handled concerns quickly and escalated to appropriate departments.
- Answered 200+ customer calls per day with FCR of 85% and reduced hold times by 30%
- Resolved customer concerns in billing, service, claims and quality.
- Shared expertise of Progressive products and services to customers to ensure appropriate insurance coverage.
Patient Care Associate
Elevance Health
01.2023 - 03.2023
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Guided members and providers with their healthcare needs by explaining benefits, solving claim concerns, and helping find a doctor.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
Program Coordinator (contract)
Centene, Superior Health Services
10.2022 - 01.2023
- Collaborated with other program coordinators to achieve consistency in program objectives and services.
- Made outbound lead follow-ups to potential and existing members by telephone to enroll into case management.
- Completed various administrative tasks such as making phone calls, answering emails and inputting data into systems.
- Documented each patients' activity in program-specific databases.
- Maintained up-to-date and accurate contacts and progress note records.
Utilization Review Specialist
Magellan Healthcare
10.2021 - 02.2022
- Performed prior authorization review of services requiring notification.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Office Clerical Aide (contract)
TriPharm
02.2021 - 09.2021
- Maintained financial documents and office bookkeeping using Excel.
- Developed spreadsheets for managers.
- Scanned and transferred paper documents into excel system.
- Skilled with computers, photocopiers, scanners and voice mail systems.
- Managed daily data entry and kept clerical information accurate and up-to-date.
- Maintained and updated office records, both digital and physical.
Education
Associate of Applied Science -
Tarrant County College District
Fort Worth, TXSkills
- Information Security
- Product Knowledge
- Data Collection
- Appointment Scheduling
- Account Updating
- Call Management
- Claims Processing
- Eligibility Review
- Case Management
- Eligibility Determination
- Patient Communication
- Written and Verbal Communication
Timeline
Customer Service Representative
Progressive
04.2023 - 11.2023
Patient Care Associate
Elevance Health
01.2023 - 03.2023
Program Coordinator (contract)
Centene, Superior Health Services
10.2022 - 01.2023
Utilization Review Specialist
Magellan Healthcare
10.2021 - 02.2022
Office Clerical Aide (contract)
TriPharm
02.2021 - 09.2021
Associate of Applied Science -
Tarrant County College District
Similar Profiles
MORGAN DAVISMORGAN DAVIS
Claims Generalist at ProgressiveClaims Generalist at Progressive
Shaindia Grier-StillwellShaindia Grier-Stillwell
Insurance Agent at ProgressiveInsurance Agent at Progressive
Stevie HallStevie Hall
Managed Repair Representative at ProgressiveManaged Repair Representative at Progressive
Jason SpielmanJason Spielman
Managed Repair Representative at ProgressiveManaged Repair Representative at Progressive
Rachel CarterRachel Carter
Professional Reviewer at American Association of Nurse Practitioners-Certification BoardProfessional Reviewer at American Association of Nurse Practitioners-Certification Board