JASHARAE HART
Grand Prairie,TX
Summary
- Developed strong foundation in customer service and analytical skills within high-paced claims environment, seeking to transition into new field. Leveraged expertise in data analysis and problem-solving to streamline processes and enhance client satisfaction. Looking to apply these transferable skills to drive success in new professional setting.
- Claims professional well-versed in intricacies of claim management and resolution. Known for strategic approach to resolving disputes and ensuring compliance with industry standards. Reliable team collaborator with focus on achieving optimal outcomes and adapting to changing requirements. Skilled in negotiation and critical thinking.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Claims Specialist
Elevance Health/Anthem Insurance
08.2021 - 11.2024
- As a claim specialist my job was to investigate,evaluate, and settle insurance claims
- Determine whether the insurance policy covers the loss claimed
- Decide the appropriate amount the insurance company should pay out
- Also, ensure that the claims are not done fraudulent
- Contact claimants doctors or other insurance to get additional claim questions
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Enhanced customer satisfaction by efficiently managing insurance claims processes and providing timely resolutions.
Client Services Member Representative
Health Equity
06.2020 - 07.2021
- Met strict quality standards, continuously monitoring members claims
- Complied with IRS codes with strong oversight of member account history
- Keep accounts current with updates about posted payments and outstanding balances
- Managed establishment finances, including adding receipts and inputting bank deposits
- Prepared and processed new business paperwork to assist clients in signing up for new services
- Managed first-line customer support phone calls and emails for FSA clients
- Coordinated funds transfers between different types of accounts, including at outside institutions
- Resolved customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills
Patient Care Advocate
Compass Professional
06.2018 - 06.2020
- Educated medical staff and patients by developing informational materials
- Coordinated communication between patients, family members, and medical staff
- Helped improve institutional policies based on collected, analyzed and reported encounter data
- Reduced risk and legal liabilities, consistently researching options and implementing recommendations
- Improved quality of care with diligent attention to patient needs and delivery strategies
Administration Assistant
Dallas ISD
02.2018 - 03.2019
- Supported daily operations with administrative expertise, including file management, document control, and operational reporting
- Managed office workflow, including resource allocation, scheduling, and task delegation
- Answered incoming calls, took and relayed messages, and maintained office access security
- Addressed office equipment needs related to coffee machines, appliances, printers, and postage machines
- Monitored common areas to foster welcoming and professional appearance of front desk, restrooms, and conference spaces
Phlebotomist
CSL Plasma
10.2017 - 03.2018
- Gathered blood samples from patients for tests and transfusions
- Completed accurate labels, paperwork, and system records updates with patients' sample information and personal details
- Upheld data security and compliance with HIPAA protocols through multiple identification points and document verification
- Prepared blood drawing equipment, including the plasmapheresis machine
- Minimized patients' discomfort with good use of physical techniques and conversational skills
Human Resources Assistant
Amazon
09.2015 - 06.2017
- Processed personnel paperwork, including leave-request forms, new hire packets, and benefits information
- Supported employee onboarding by coordinating new-hire orientation sessions and training new hires on facility procedures
- Assisted with payroll functions, including verifying hours worked and processing appropriate deductions and PTO accrual
- Supported HR operations by scheduling and coordinating meetings and training
Education
High School Diploma -
Crossroads Academy
06-2010
Skills
- Claims
- Claims processing
- Claims investigation
- Verbal communication
- Microsoft office
- Claims analysis
- Teamwork and collaboration
- Customer service
- Data entry
- Insurance coverage verification
- Claims adjustment
Accomplishments
- Achieved my certificate in HEDIS OPERATION by completing my Training with accuracy and efficiency.
Certification
- CPR/AED Certification
- First Aid Certification
Timeline
Claims Specialist
Elevance Health/Anthem Insurance
08.2021 - 11.2024
Client Services Member Representative
Health Equity
06.2020 - 07.2021
Patient Care Advocate
Compass Professional
06.2018 - 06.2020
Administration Assistant
Dallas ISD
02.2018 - 03.2019
Phlebotomist
CSL Plasma
10.2017 - 03.2018
Human Resources Assistant
Amazon
09.2015 - 06.2017
- CPR/AED Certification
- First Aid Certification
High School Diploma -
Crossroads Academy
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