Jasmine Fleming
Norfolk,VA
Summary
Professional with strong foundation in verification processes, ensuring accuracy and compliance. Offering 10 years of experience in quickly resolving issues and maximizing customer retention opportunities. Skilled in data analysis, problem-solving, and quality assurance. Reliable team collaborator, adaptable to changing needs, and focused on achieving results. Prepared to bring precision, integrity, and effective communication to role.
Overview
9
9
years of professional experience
1
1
Certification
Work History
ECOB Verification Specialist II
Elevance Health
Norfolk, VA
04.2021 - 02.2025
- Conducted thorough research online and via phone to verify member coverage.
- Ensure familiarity with state and carrier-specific processing guidelines.
- Analyzed incoming requests alongside system data to maintain consistency in OHI information.
- Completed urgent inventory tasks within required turnaround times.
- Maintained comprehensive COB records across applicable platforms.
- Assist with special projects, including CMS Audits, state and provider complaints and CAV enhancement specific projects
- Completed metrics-based work
- Oversee programs for health, dental, vision, life, disability, and accident insurance.
- Participated in regular performance reviews, using constructive feedback as an opportunity for growth and development within my role as a Verification Specialist.
- Reduced errors in documentation by meticulously reviewing medical records and verifying patient information.
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
OTC Member Representative
Anthem, Inc.
12.2020 - 04.2021
Medicare Application Representative
Qualfon
09.2020 - 12.2020
- Process State Medicare applications for health, vision and dental
- Answer customers' questions and addressed problems with completing an application
- Ensure participant understands benefits of each individual plan
- Calculate premiums and established payment methods
- Conduct interviews with applicants, explaining benefits process and which plans were available
Enrollment Specialist
CONDUENT
Chesapeake, VA, US
12.2019 - 03.2020
- Provided service for new and existing patients to enroll or re-enroll in program
- Recorded patients demographic information and, collected any insurance card information
- Provided patients with program benefits, and any information pertaining to their support accounts
- Delivered excellent and efficient customer service skills as well as deescalating any irate patients with problem solving skills
- Maneuvered through various systems multitasking as well as having active listing skills to get task handled promptly
- Conducted interviews with applicants, explaining benefits process and which programs were available
- Reviewed criteria for different aid programs to determine eligibility for various applicants
- Inputted all communication with applicants into computer system to facilitate future clarification and knowledgeable support
Direct Support Professional
ST. MARY'S HOME FOR CHILDREN
Norfolk, VA, US
11.2018 - 04.2019
- Supported and provided daily care for children with intellectual disabilities
- Completed entries in log books, journals and care plans to document accurately report progress and vitals
- Handling patients records
- Developed rapport with the children to create safe and trusting, and fun environment for care
- Conducted supervised daily activities and provided assistance when needed
- Monitored progress and documented any status changes accordingly
- Maintained clean, safe and well-organized environments for the children
Customer Service Specialist
UPS
Newport News, VA, US
11.2018 - 01.2019
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints
- Displayed strong telephone etiquette, effectively handling difficult calls
- Processed orders, keeping customers advised of status
- Processed claims for missing merchandise during deliveries
Claims Support Representative
SUTHERLAND GLOBAL SERVICES
Chesapeake, VA, US
02.2018 - 08.2018
- Assessed caller accounts to determine Short-Term/Long-Term Disability claim benefits, identify service needs and resolve issues
- Displayed knowledge of medical terminology and ICD coding for insurance claims
- Registered customers into system
- Conducted interviews with customers starting new insurance claims or having existing claims
- Guided Customers through filing a claim, requesting information on an existing claim, and making any changes or updates
- Consult with healthcare providers/facilities for the retrieval of medical documentation
- Built rapport and trust with injured insureds through effective customer service techniques which involved fair and prompt processing of claims
- Investigated and compared insurance policies
Technical Support Advisor
IBEX Global
Hampton, VA, US
08.2017 - 02.2018
- Serviced a wide variety of clients with technical support for all Apple products
- Provided troubleshooting for all apple products and software
- Used Problem solving skills to help customers resolve their issues by the end of the call
- Use screen sharing techniques to remotely access customers devices and troubleshoot
- Operated through multiple systems
Medical Claims Processor
DOMA TECHNOLOGIES LLC
Virginia Beach, VA, US
06.2016 - 06.2017
- Analyzed & identified various claims issues before completion
- Contacted healthcare providers to confirm appointment statuses for claims purpose
- Ensured claims were billed and paid correctly
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology, insurance coding and other procedures
- Based the payment or denials of medical claims upon well-established criteria for claims processing
Education
Associate's degree - Medical Billing & Coding
Penn foster college
02.2023
HIGH SCHOOL DIPLOMA -
Tidewater Community College
01.2016
High school diploma or GED -
Maury High School
Norfolk, VA01.2014
Skills
- Time management
- Critical Thinking
- Claims review and processing
- Technologically advanced
- Quality auditing to ensure accuracy
- Microsoft Office expertise
- Payments posting
- Medical billing/coding
- Software troubleshooting
- Insurance verification
- Document verification
- HIPAA compliance
- Insurance billing
- Data entry and review
- Coordination and scheduling
- Strong written and verbal communication skills
- Coverage and prior authorizations
Certification
CPR Certification
Personal Information
Authorized To Work: US for any employer
Timeline
ECOB Verification Specialist II
Elevance Health
04.2021 - 02.2025
OTC Member Representative
Anthem, Inc.
12.2020 - 04.2021
Medicare Application Representative
Qualfon
09.2020 - 12.2020
Enrollment Specialist
CONDUENT
12.2019 - 03.2020
Direct Support Professional
ST. MARY'S HOME FOR CHILDREN
11.2018 - 04.2019
Customer Service Specialist
UPS
11.2018 - 01.2019
Claims Support Representative
SUTHERLAND GLOBAL SERVICES
02.2018 - 08.2018
Technical Support Advisor
IBEX Global
08.2017 - 02.2018
Medical Claims Processor
DOMA TECHNOLOGIES LLC
06.2016 - 06.2017
HIGH SCHOOL DIPLOMA -
Tidewater Community College
High school diploma or GED -
Maury High School
Associate's degree - Medical Billing & Coding
Penn foster college