Summary
Overview
Work History
Education
Skills
Timeline
background-images

Jessica Cantrell

Fayette,AL

Summary

Dynamic Appeals Specialist with a proven track record at CVScaremark, excelling in the appeals process and ensuring HIPAA compliance. Recognized for exceptional customer service and strong analytical skills, I effectively managed high-stress situations, expediting resolution times and enhancing client satisfaction through meticulous documentation and effective communication.

Overview

13
13
years of professional experience

Work History

Appeals Specialist

CVScaremark
09.2023 - Current
  • Analyzed and processed appeals for medication coverage, ensuring compliance with regulatory standards.
  • Collaborated with healthcare providers to gather necessary documentation for appeal resolutions.
  • Reviewed and interpreted policy guidelines to determine eligibility for benefit claims effectively.
  • Maintained accurate records of appeal outcomes and communicated findings to relevant stakeholders.
  • Assisted in training new team members on appeal processes and system navigation tools.
  • Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
  • Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
  • Educated clients on their rights and responsibilities throughout the appeals process, ensuring a clear understanding of expectations and potential outcomes.
  • Regularly received commendations from supervisors for demonstrating exceptional commitment to customer service and dedication to client satisfaction throughout the appeals process.
  • Conducted comprehensive training sessions for new hires on proper procedures for processing claims denials and managing appeals caseloads.
  • Demonstrated exceptional attention to detail when evaluating medical records in order to identify discrepancies or inconsistencies that could impact an appeal''s outcome positively or negatively.
  • Coordinated with senior specialist to compose appeal responses.
  • Maintained strict confidentiality of patient information in accordance with HIPAA regulations.

Pharmacy Technician

Express Rx
01.2013 - 09.2023
  • Processed and dispensed medications accurately to ensure patient safety.
  • Assisted in inventory management, tracking stock levels and expiration dates.
  • Provided exceptional customer service by addressing inquiries and resolving issues.
  • Supported pharmacists in preparing compound medications per prescriptions.
  • Maintained cleanliness and organization of pharmacy workspace to comply with regulations.
  • Operated pharmacy software for prescription processing and patient records management.
  • Collaborated with healthcare professionals to ensure timely medication delivery.
  • Adhered to safety protocols while handling hazardous materials and pharmaceuticals.
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
  • Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
  • Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
  • Counted and labeled prescriptions with correct item and quantity.

Receptionist

Bolling Plastic Surgery
08.2021 - 10.2022
  • Managed front desk operations, ensuring seamless patient check-in and appointment scheduling.
  • Assisted patients with inquiries, providing exceptional customer service and addressing concerns promptly.
  • Maintained accurate patient records using electronic health record systems to enhance data accessibility.
  • Coordinated communication between medical staff and patients, streamlining information flow for efficient care delivery.
  • Implemented office procedures that improved workflow efficiency and reduced patient wait times.
  • Monitored inventory levels of medical supplies, facilitating timely reordering to avoid shortages.
  • Organized patient follow-up appointments and reminders, enhancing overall patient engagement and satisfaction.
  • Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
  • Confirmed appointments, communicated with clients, and updated client records.
  • Answered phone promptly and directed incoming calls to correct offices.
  • Kept reception area clean and neat to give visitors positive first impression.
  • Resolved customer problems and complaints.
  • Handled cash transactions and maintained sales and payments records accurately.
  • Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
  • Responded to inquiries from callers seeking information.

Education

Bevill State Community College
Sumiton, AL

Skills

  • Organizational growth
  • HIPAA compliance
  • Effective communication
  • Professionalism and ethics
  • Continuous learning mindset
  • Strong analytical skills
  • Data entry proficiency
  • Problem-solving capacity
  • Documentation expertise
  • Appeals process proficiency
  • Insurance policies
  • Teamwork

Timeline

Appeals Specialist

CVScaremark
09.2023 - Current

Receptionist

Bolling Plastic Surgery
08.2021 - 10.2022

Pharmacy Technician

Express Rx
01.2013 - 09.2023

Bevill State Community College

Similar Profiles

CREATE PROFILE
Jessica Cantrell