Melissa Jackson
Henderson,NC
Summary
I’ve worked in customer service for 9 years and am known for my excellent work ethic and passion for creating a great customer experience. I have practiced my skills in customer deescalation through restaurant management as well as working with escalated customers to resolve issues as a resolutions supervisor at 1-800-Pack-Rat call center. I then moved on to Benefit Verification where I became knowledgeable with processing insurance claims, completing prior authorizations and working with insurance companies and medical offices to get patient’s their much needed medications. I am a hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
10
10
years of professional experience
Work History
Benefit Verification Specialist
Continuum Global Solutions
Henderson, North Carolina
10.2023 - Current
- Explained the requirements for obtaining pre-authorization from insurers.
- Processed requests from physicians' offices for pre-authorization of tests or treatments.
- Facilitated communication between providers and payers when there were disputes over claim payments.
- Assisted customers in understanding their benefits package and how it relates to their individual needs.
- Managed correspondence between patients, providers, and payers regarding authorization status.
- Collaborated with medical staff to ensure accuracy of patient records and eligibility for services.
- Identified discrepancies in patient benefit information and resolved them with the insurance provider.
- Worked closely with other departments within the organization as needed.
- Conducted data entry into relevant systems regarding benefit verifications.
- Provided assistance with claims processing when needed, including filing appeals as necessary.
- Maintained accurate records of all verifications, including date of service, procedure codes, diagnosis codes.
Resolutions Supervisor
1-800-pack-rat
Oxford, NC
06.2022 - 09.2023
- Documented all escalations including resolution steps taken as well as root cause analysis.
- Provided customer service and resolution to inquiries received via telephone, email, and web.
- Answered questions regarding product availability and pricing information.
- Processed orders for products and services.
- Responded to customer complaints in a timely manner.
- Followed up with customers after resolution of an issue to ensure satisfaction.
- Utilized problem-solving skills when faced with difficult situations involving customers.
- Provided support for internal teams by answering questions or providing resources related to customers' needs.
- Enhanced productivity and customer service levels by anticipating needs and delivering outstanding support.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Department Manager
McDonald's
Oxford, NC
12.2014 - 06.2022
- I provide exceptional customer service, count and deposit money daily, monitor crew and the floor
- I help to calm customers and assist them if they have experienced any issue at the restaurant
- I also make sure other crew are completing their assigned tasks in a timely manner
- I keep the crew focused by setting goals for specific time periods as well as daily goals
- I oversee hiring for the restaurant as well as scheduling, crew morale and appearance
- I help insure that all crew are representing the company in the upmost professional manner
- I also help with counting daily, weekly and monthly inventory and placing orders for product
- I input the inventory data into the system and compare data for the month with our goals.
Education
High School Diploma -
J.F. Webb High School
Oxford, NC06-2016
Some College (No Degree) - Human Services Technology
Vance-Granville Community College
Skills
- Customer Service (9 years)
- Data Entry (7 years)
- HIPAA compliance
- Claims processing
- Insurance verification
- Customer deescalation
- Time management
- Microsoft office
- Verbal and written communication
- Benefits explanation
- Shift Supervisor
- Team Member
- Inventory
- Training
- Team Building
- Cash Handling
- Management
- Restaurant Management
- Leadership
- Speed typing
- Microsoft
References
Denise Carraway 919-691-0426
Taylor Cooke 919-603-7997
Summer Evans (919) 741-8354
Timeline
Benefit Verification Specialist
Continuum Global Solutions
10.2023 - Current
Resolutions Supervisor
1-800-pack-rat
06.2022 - 09.2023
Department Manager
McDonald's
12.2014 - 06.2022
High School Diploma -
J.F. Webb High School
Some College (No Degree) - Human Services Technology
Vance-Granville Community College