Jamie Shelton
Clearfield,UT
Summary
Customer Service Representative with 10+ years of healthcare-focused support, skilled at resolving inquiries across phone, email, and chat to improve patient satisfaction. Manages scheduling and billing interactions with attention to HIPAA compliance and accurate documentation. Seeks to apply efficient communication and time-management to enhance patient experience.
Overview
10
10
years of professional experience
Work History
Customer Care Representative
Everise-CVS
Plantation, Florida
08.2026 - Current
- Managed pharmacy benefit programs to optimize patient access and cost efficiency.
- Worked with insurance companies to process claims, resolve problems and obtain payments.
- Oversaw claim processing to resolve issues and improve operational workflows.
- Collaborated with healthcare providers to enhance medication management strategies.
Patient care coordinator
Prime therapeutics specialty pharmacy
Orlando, USA
11.2025 - 05.2026
- Coordinated home infusion shipments with specialty pharmacies and couriers, ensuring on-time delivery for patient treatment schedules.
- Reviewed specialty medication prior authorizations in Surescripts and payer portals to ensure timely patient access to necessary therapies.
- Documented medication changes and clinical notes in pharmacy management system, maintaining accurate and compliant patient records.
Customer Service Representative
Cambia Health Solutions Regence
Portland, USA
03.2025 - 09.2025
- Developed and maintained strong relationships with customers, resulting in increased loyalty and repeat business.
- Engaged with customers via phone, email, and live chat, delivering consistent and responsive service.
- Managed daily operations of the customer service department, optimizing workflow and maintaining service standards.
Medical Receptionist/Customer Service
Medallus Medical Urgent Care
Layton, USA
04.2024 - 01.2025
- Greeted patients and provided excellent customer service at a busy urgent care facility.
- Managed appointment scheduling and maintained accurate patient records efficiently.
- Coordinated patient scheduling and appointments to streamline office workflow and improve patient experience.
- Maintained patient records and ensured HIPAA compliance to protect confidentiality and uphold data integrity.
- Verified insurance information and processed patient payments promptly and accurately.
Insurance Billing Specialist
Tanner Clinic
Kaysville, USA
05.2022 - 02.2024
- Processed insurance claims accurately and efficiently for patient services.
- Gathered necessary documentation for claim submissions in collaboration with the healthcare team, improving claim accuracy.
- Resolved billing discrepancies and inquiries by communicating with insurance carriers and patients in a timely manner.
- Reviewed billing discrepancies and resolved issues with insurance providers.
- Managed patient accounts and updated insurance information consistently.
Healthcare Specialist/Teamlead
Connexion Point
Sandy, USA
09.2016 - 02.2022
- Handled patient information with confidentiality, ensuring compliance with HIPAA regulations to protect patient privacy.
- Utilized comprehensive knowledge of products and services to provide accurate information and tailored recommendations to patients.
- Delivered exceptional customer service by promptly addressing inquiries and resolving issues, ensuring a positive customer experience.
- Recorded customer interactions accurately, ensuring adherence to company policies and regulations for quality assurance.
Education
High School Diploma -
Doris Academy
UT, USASkills
- Inquiry management
- Customer Relationship Management
- Claims processing
- Insurance verification
- Patient documentation
- Claim processing
- HIPAA Compliance
- Data Entry
Timeline
Customer Care Representative
Everise-CVS
08.2026 - Current
Patient care coordinator
Prime therapeutics specialty pharmacy
11.2025 - 05.2026
Customer Service Representative
Cambia Health Solutions Regence
03.2025 - 09.2025
Medical Receptionist/Customer Service
Medallus Medical Urgent Care
04.2024 - 01.2025
Insurance Billing Specialist
Tanner Clinic
05.2022 - 02.2024
Healthcare Specialist/Teamlead
Connexion Point
09.2016 - 02.2022
High School Diploma -
Doris Academy