Jazzmine Evans

• Prepared reports summarizing current inventory levels, orders received and shipped.
• Supported other departments by providing requested information about products or services.
• Developed processes for efficient tracking of materials throughout the supply chain process.
• Processed customer orders according to established guidelines and timelines.
• Maintained cleanliness and organization of warehouse stockrooms.
• Assisted with special projects such as cycle counting, reorganizing inventory storage areas.

• Handle incoming member and provider calls regarding claim status, benefits, and eligibility.

• Review claim submissions and navigate DG to obtain claim detail information.

• Assist and shadow new hires to help them get acquainted with call center expectations.

• Adhere to Aetna values and behaviors to ensure daily performance is guaranteed.

• Maintain broad knowledge of performance metrics and exceed expectations monthly.

• Precisely verify health plan coverage and provide explanation on claim processing.

• Reviewed and analyzed insurance claims to determine validity, completeness, accuracy,

and eligibility for payment.

• Investigated complex or high-value claims to identify discrepancies and fraud indicators.

• Researched medical records to evaluate claim validity and verify the existence of

pre-existing conditions.

• Processed payments for valid claims according to established procedures.

• Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.

•Interpreted legal documents related to claims processing such as contracts and policy language .