Summary
Overview
Work History
Education
Skills
Timeline
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JASMINE MELROSE

BALCH SPRINGS,TX

Summary

Dedicated healthcare professional with 10+ years of experience in patient access, insurance coordination, and medical claims processing. Proven ability to guide patients and providers through complex healthcare systems with professionalism, accuracy, and empathy. Skilled in resolving barriers to care, managing prior authorizations, and ensuring timely access to services. Seeking to leverage strong communication, coordination, and problem-solving skills in a Case Manager role to improve patient outcomes and streamline care.

Experienced with patient registration, insurance verification, and managing patient inquiries. Uses effective communication to ensure seamless patient interactions and adherence to healthcare protocols. Track record of enhancing patient satisfaction through efficient and compassionate service.

Overview

10
10
years of professional experience

Work History

PATIENT ACCESS SPECIALIST

Cencora
01.2022 - Current
  • Deliver support services for manufacturer-sponsored healthcare programs, including benefit verification, prior authorizations, and financial assistance.
  • Manage inbound and outbound communications with patients and providers, ensuring prompt responses and effective issue resolution.
  • Support billing and reimbursement processes for specialty medications, increasing patient adherence to therapy.
  • Document all communications to ensure accuracy in profile updates and adverse event reporting.
  • Serve as a liaison among field management, healthcare providers, and patients to resolve issues efficiently.
  • Identify patterns in service delivery and member needs, providing insights and recommendations for program and operational improvements.

MEDICAL REIMBURSEMENT PROCESSOR

Willis Towers Watson
03.2019 - 12.2021
  • Reviewed, evaluated, and processed medical and pharmacy out-of-pocket reimbursement requests in accordance with IRS guidelines.
  • Demonstrated strong teamwork by supporting colleagues, contributing to special projects, and assisting with product initiatives.
  • Accurately entered and updated claim information in internal systems while maintaining HIPAA and company compliance.
  • Consistently exceeded daily productivity and quality requirements in a fast-paced, deadline-driven environment.

HEALTHCARE CUSTOMER SERVICE REPRESENTATIVE

Willis Towers Watson
09.2015 - 03.2019
  • Provided high-quality, empathetic support to Medicare beneficiaries, addressing inquiries related to benefits, coverage, and health claim reimbursements.
  • Handled high-volume inbound and outbound calls while maintaining performance metrics for quality, call handling time, and patient satisfaction.
  • Resolved member issues related to Medicare claims and billing discrepancies by researching policy guidelines and collaborating with internal departments.
  • Enhanced patient-centered support while ensuring all communications and documentation adhered to HIPAA standards.

Education

BACHELOR OF SCIENCE - BUSINESS MARKETING

Grambling State University
Grambling, LA
12.2015

Skills

  • Case Management
  • Patient Advocacy
  • Care Coordination
  • Prior Authorizations
  • Benefit Verification
  • Insurance Navigation
  • Claims Resolution
  • HIPAA Compliance
  • PHI
  • Medical terminology
  • HIPAA compliance
  • Professionalism and ethics
  • Documentation accuracy
  • Performance standards compliance
  • Insurance verification
  • Problem-solving
  • Multitasking and organization

Timeline

PATIENT ACCESS SPECIALIST

Cencora
01.2022 - Current

MEDICAL REIMBURSEMENT PROCESSOR

Willis Towers Watson
03.2019 - 12.2021

HEALTHCARE CUSTOMER SERVICE REPRESENTATIVE

Willis Towers Watson
09.2015 - 03.2019

BACHELOR OF SCIENCE - BUSINESS MARKETING

Grambling State University
JASMINE MELROSE