Jasmine Melrose
Mesquite,TX
Summary
Results-driven Case Manager with 5+ years of experience across patient access, claims processing, and insurance navigation within complex healthcare and pharmaceutical programs. Proven ability to manage end-to-end case lifecycles, resolve payer barriers, and improve patient access to therapy. Recognized for maintaining a 98% quality assurance score and improving case resolution timelines by up to 30%. Experienced in supporting a Sanofi-sponsored program and currently pursuing Certified Case Manager (CCM) certification.
Overview
2027
2027
years of professional experience
Work History
Case Manager
Johnson & Johnson
Remote
2026 - Current
- Manage end-to-end case coordination, ensuring timely patient access to therapy and continuity of care
- Navigate complex insurance processes including benefit verification, prior authorizations, and appeals
- Identify and resolve payer barriers through collaboration with providers, payers, and specialty pharmacies
- Develop and implement patient-centered care plans to support treatment initiation and adherence
- Serve as a liaison across patients, providers, and internal teams to ensure seamless coordination
Patient Access Specialist
Cencora
Remote
2023 - 2026
- Supported patient access services for a Sanofi-sponsored program, ensuring alignment with program guidelines
- Performed benefits investigations, prior authorizations, billing, and claims tracking across multiple payer systems
- Improved case resolution timelines by 30% through proactive issue identification and follow-up
- Maintained a 98% quality assurance score, consistently exceeding performance benchmarks
- Conducted onboarding and welcome calls, improving patient engagement and retention
- Collaborated with providers, pharmacies, and internal teams to streamline therapy access
Claims Processor
Willis Towers Watson
Richardson, TX
2019 - 2022
- Processed 50+ medical and reimbursement claims daily with a 98% accuracy rate
- Reviewed HSA accounts and Medicare-related claims in compliance with IRS and payer guidelines
- Investigated and resolved claim denials, reducing processing errors and delays
- Interpreted EOBs and insurance policies to support accurate reimbursement outcomes
- Identified trends in claim issues and contributed to process improvements
Healthcare Customer Service Representative
Willis Towers Watson
Richardson, TX
2016 - 2019
- Assisted Medicare patients with claims, eligibility, and appeals processes
- Resolved escalated inquiries with empathy, improving patient understanding and satisfaction
- Increased first-call resolution by providing clear, actionable guidance
Education
Bachelor of Science - Marketing
Grambling State University
Grambling, LA12-2015
Skills
- Patient Access & Case Management
- Insurance Verification & Prior Authorizations
- Claims Processing & Appeals
- Reimbursement & Payer Navigation
- Medicare & Medicaid
- CRM Systems (Salesforce)
- Provider & Payer Relations
- Patient Advocacy
- Compliance & Risk Review
- Process Improvement
Timeline
Case Manager
Johnson & Johnson
2026 - Current
Patient Access Specialist
Cencora
2023 - 2026
Claims Processor
Willis Towers Watson
2019 - 2022
Healthcare Customer Service Representative
Willis Towers Watson
2016 - 2019
Bachelor of Science - Marketing
Grambling State University