Jamie Blankenship
Green Cove Springs
Summary
Analytical and proactive professional woman specializing in claims processing, customer service, and process improvement. Known for strong collaboration and problem-solving skills, contributing to impactful solutions that enhance client engagement and operational processes.
Overview
14
14
years of professional experience
Work History
Consultant
Florida Blue
2020.09 - 2025.10
- Collaborated with teams to establish claim rules, ensuring accurate application of benefits for Medicare claims.
- Utilized SQL and TOAD data tools to generate impact reports, assisting leaders with inventory analysis and trend assessment
- Collaborated with IT teams on various projects, ensuring deadlines were met.
- Collaboration with compliance team to ensure adherence to CMS standards and regulations utilizing Medicare online Materials
- Reviewed Health Insurance claims to identify trends of denials, over-applied cost shares, or impact analysis reports to support Internal audits and CMS audits (ODAG)
- Implemented process improvements for cross-functional projects that led to $500k in Medical Cost savings
- Facilitated resolution of Medicare member complaints through effective email correspondence
- Analyzed client needs to recommend tailored healthcare solutions.
- Collaborated with cross-functional teams to enhance service delivery processes.
- Supported project management efforts by coordinating timelines and resources.
- Evaluated program effectiveness through data analysis and feedback collection.
- Provided advice on operational processes, business development initiatives, organizational changes and other areas of improvement.
- Analyzed complex information from multiple sources to identify patterns or trends.
- Managed multiple projects simultaneously ensuring timely completion within budget constraints.
Analyst
Florida Blue - Blue Cross Blue Shield Of Florida
2014.07 - 2020.09
- Analyzed Commericial, Medicare, and Employer Group claims to identify trends and support decision-making processes.
- Developed reports utilizing SQL highlighting key performance indicators for management review.
- Collaborated with cross-functional teams to streamline operational workflows and enhance efficiency.
- Led initiatives to improve data accuracy and integrity across multiple systems.
- Reviewed interest payments made on claims and performed root cause analysis to determine accuracy of interest payment
- Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
- Enhanced customer satisfaction rates through detailed analysis of customer feedback data and subsequent improvements in service offerings.
Customer Service Advocate
Florida Blue - Blue Cross Blue Shield Of Florida
2011.06 - 2014.07
- Responded to inquiries from members and providers in a call center setting, ensuring effective resolution of benefits and claims issues
- Resolved customer inquiries and issues through effective communication and problem-solving skills.
- Provided guidance on denial reasons,cost share details, appeal status/rights, ensuring customers understood benefits and coverage details.
- Assisted customers with claims processing, enhancing their understanding of procedures and timelines.
- Collaborated with cross-functional teams to streamline service processes for improved efficiency.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Managed high call volume during peak hours, prioritizing urgent cases while maintaining attention to detail.
- Maintained a positive work environment, fostering team collaboration and continuous improvement.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Supported call center associates by taking on escalated calls, handling complex concerns and achieving customer satisfaction targets.
Education
High School Diploma -
Nation High School
Jacksonville, Fl05.2009
Skills
- Claims evaluation
- SQL data analysis expertise
- Data interpretation
- Operational efficiency enhancement
- Project oversight
- Effective communication
- Trend analysis expertise
- Analytical problem solving
- Proficient in conflict management
- Customer relationship management
- Client engagement
- Collaborative teamwork
- Continuous improvement
- Subject matter expert
- Professional presentation skills
- Reports and documentation
- Analytical thinking
- Reliability and trustworthiness
- Trend analysis
- Business analysis
- Meticulous attention to detail
- Time management
- Clear and concise communication
- Analysis & evaluation
- Processes and procedures
- MS office
- MySQL
Accomplishments
Growing Yourself, Your Skills, and your career workshop
Timeline
Consultant
Florida Blue
2020.09 - 2025.10
Analyst
Florida Blue - Blue Cross Blue Shield Of Florida
2014.07 - 2020.09
Customer Service Advocate
Florida Blue - Blue Cross Blue Shield Of Florida
2011.06 - 2014.07
High School Diploma -
Nation High School