Jazlyn Staten
Houston,TX
Summary
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
12
12
years of professional experience
Work History
Eligibility Specialist
Conduent
02.2022 - Current
- Provide detailed information about health plan benefits, including covered services, co-pays, deductibles, and out-of-pocket maximums.
- Confirm eligibility for services and coverage limits, ensuring members understand what is and isn't covered by their plan. Check members' plan status, effective dates, and any restrictions on coverage for specific treatments or providers.
- Manage a high volume of inbound calls, emails, or chats, providing accurate and efficient responses to each inquiry.
- Review claims with members, explain reasons for denials, and provide guidance on resubmissions or appeals if necessary.
Medical Claims Specialist
Allied Benefit Systems Inc.
12.2019 - 02.2022
- Answer inbound calls from healthcare providers, patients, and insurance representatives regarding medical claims, payment status, and coverage details.
- Process payments for approved claims, ensuring that all amounts are accurate and compliant with insurance policies and contractual agreements.
- Coordinate payment disbursements to healthcare providers or patients, ensuring timely and accurate payments.
- Assess claims based on insurance policies, medical necessity, and coverage guidelines to approve or deny payments. Ensure that claims meet compliance with regulatory requirements (e.g., HIPAA Medicaid/Medicare, private insurance guidelines).
Billing Customer Service Representative
Ferguson
08.2016 - 12.2019
- Handle a high volume of inbound calls from customers regarding their billing statements, charges, payments, and account balances.
- Investigate and resolve issues related to billing errors, Assist customers with making payments over the phone, including setting up payment plans, accepting credit card or bank information, and updating billing details.
- Provide clear explanations to customers regarding charges, credits, and payment terms on their invoices.
- Meet key performance indicators (KPIs) such as call handling time, resolution time, and customer satisfaction scores.
Technical Support Representative
DISH
02.2014 - 08.2016
- Offer prompt and courteous assistance to end-users experiencing technical issues via phone, email, or ticketing system.
- Troubleshoot and resolve hardware, software, and network problems, escalating complex issues to senior technicians when necessary.
- Accurately document all support interactions, including issue descriptions, troubleshooting steps, and resolutions, in the help desk ticketing system.
- Ensure thorough and up-to-date records to facilitate efficient problem resolution and knowledge sharing among team members.
Education
High School Diploma - undefined
Skills
- ICD-10
- Claims Processing
- Insurance Verification
- Provider Relations
- EOB Analysis
- Customer Service
- Insurance Claims
- Problem-Solving
- Inbound/Outbound Calling
- Email Support
- Chat Support
- Time Management
- Healthcare Customer Support
- Benefits Explanation
- Call Management
- Eligibility determination
- Payment processing
- Customer relationship management (CRM)
- Technical support
- Customer service expert
- Ticket support system management
Timeline
Eligibility Specialist
Conduent
02.2022 - Current
Medical Claims Specialist
Allied Benefit Systems Inc.
12.2019 - 02.2022
Billing Customer Service Representative
Ferguson
08.2016 - 12.2019
Technical Support Representative
DISH
02.2014 - 08.2016