Lajoya Jackson
Little Rock,AR
Summary
Highly skilled and experienced professional with expertise in customer service roles. Proven ability to effectively communicate with customers, patients, physicians, and colleagues. I am proficient in insurance claims, benefits eligibility, and white glove customer service. Strong attention to detail, accuracy, and problem-solving skills. Demonstrated commitment to providing exceptional customer service and support in a fast-paced environment.
Overview
8
8
years of professional experience
Work History
Patient Access Representative
Mercy Hospital ED
Fort Smith, Arkansas
07.2024 - Current
- Answered incoming calls, obtained and verified patient information, patient check in/out, coordinated, and facilitated patient appointments.
- Maintained strict confidentiality of patient information in electronic systems as established by the appropriate protocols and policies.
- Educated and advised patients on specified medical issues within established parameters.
- Completed physician orders and facilitated specialists’ care, which may result in phoning patient prescriptions.
- Prepared prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines.
- Facilitated prompt payment of approved claims by liaising with finance department to ensure smooth transaction processing.
- Served as a subject matter expert on specialized claims, providing guidance and support to other team members when needed.
- Researched denied claims, conducted coding reviews of medical records, and supported documentation against denied claims.
- Corresponded to patient and physician’s questions regarding EOB’s, patient balances, co-pays, deductibles, write-offs, etc.
Benefits Verifications Representative
Alopexx
04.2022 - 06.2024
- Completed medical and/or pharmacy benefit investigations.
- Identified and requested submission of required documentation for payer/plan.
- Provided excellent customer service to patients, physicians, colleagues and superiors in a professional manner.
- Reviewed detailed patient information for payment resolution while abiding HIPPA privacy and security regulations.
- Demonstrated understanding of insurance verification policies and procedures.
- Contacted insurance carriers to discuss policies and individual patient benefits.
- Facilitated payment of approved claims by liaising with the finance department to ensure smooth transaction processing.
- Recognized patterns of inconsistent and/or inaccurate claims filing and billing practices among customers and providers.
- Provided itemized billing statements and screen HIPAA authorization forms for hundreds of legal firms.
- Resolved denied/rejected invoices and prepared payer corrections and appeals.
- Reviewed accounts and assisted with resolving outstanding balances with patients from clinic visits.
Dietetic Technician
UAMS Hospital
Little Rock, AR
11.2021 - 03.2022
- Assisted patients by ensuring timely delivery of meals per dietary orders and allergies.
- Proactively gathered food orders from patients with communication difficulties or language barriers.
- Managed electronic meal selections for room service and house selection criteria.
- Updated patient information in the electronic medical record, correcting menu choices as needed.
- Served meal trays promptly, adhering to departmental policies and procedures.
- Utilized two patient identifiers to accurately match meals with patients.
- Troubleshot service issues at the point of delivery to enhance patient satisfaction.
Member Services Representative
The Jackson Group
03.2020 - 03.2022
- Maintained database by entering new and updated patient and account information.
- Processed customer and account source documents by reviewing data for deficiencies.
- Reviewed detailed patient information for payment resolution while abiding HIPPA privacy and security regulations.
- Processed medical claims using special appeals processing instructions for commercial and government carriers.
- Recognized patterns of inconsistent and/or inaccurate claims filing and billing practices among customers and providers.
- Provided itemized billing statements and screen HIPAA authorization forms for hundreds of legal firms.
- Resolved denied/rejected invoices and prepared payer corrections and appeals.
- Reviewed accounts and assisted with resolving outstanding balances with patients from clinic visits.
- Built sustainable relationships and engaged patients by taking the extra mile.
Customer Support Representative
Wipro
Little Rock, Arkansas
08.2018 - 03.2020
- Answered incoming calls for members in reference to insurance benefits.
- Navigated through multiple computer applications with speed and accuracy.
- Adhered to HIPAA policies and protocols, becoming HIPAA certified.
- Called insurance companies and healthcare physicians on behalf of members per the company.
- Navigated through multiple computer applications with speed and accuracy.
- Built sustainable relationships and engaged patients by taking the extra mile.
- Kept records of all conversations in call center databases in a comprehensible manner.
- Maintained expectations regarding call quality and resolution time.
- Recognized patterns of inconsistent and/or inaccurate claims filing and billing practices among customers and providers.
- Explained explanation of benefits to members.
Education
High School Diploma -
SIATECH Charter High School
Little Rock, ARSkills
- Microsoft Office Proficiency
- Multitasking Skills
- Analytical Skills
- Data Entry & 10 Key Proficiency
- Insurance Reimbursement
- Medical Terminology
- Active Listening Skills
- Time Management & Organization
- Complex Problem-Solving Skills
- Type 60 PM
- Benefits Verification
- Patient registration
- HIPAA compliance
- Insurance verification
- Customer service
- Patient check-in
- Appointment scheduling
- Registration and admissions
- Medical terminology
- Healthcare systems navigation
- EMR
Timeline
Patient Access Representative
Mercy Hospital ED
07.2024 - Current
Benefits Verifications Representative
Alopexx
04.2022 - 06.2024
Dietetic Technician
UAMS Hospital
11.2021 - 03.2022
Member Services Representative
The Jackson Group
03.2020 - 03.2022
Customer Support Representative
Wipro
08.2018 - 03.2020
High School Diploma -
SIATECH Charter High School