Paula Jackson
Spring,TX
Summary
Hardworking and dedicated professional with dynamic experience across multiple fields and various roles. Demonstrated success leveraging a strong work ethic and consistent effort to meet performance benchmarks and organizational goals. Quick learner who adapts to new systems and programs within high-volume, fast paced environments.
Overview
8
8
years of professional experience
Work History
Customer Service Advocate
Cigna
04.2022 - 10.2022
- Directly supported 20-30 clients each day in better understanding their medical and dental coverage, answering questions regarding enrollment and benefits
- Transferred customers with Medicaid concerns to the correct department and provided information on resources
- Utilized internal databases to identify healthcare providers within network and verify insurance coverage and co-pays
- Assisted clients with educational information regarding other services and benefits, such as transportation resources
- Took ownership of client issues, resolving billing discrepancies in the event that clients did not properly disclose Medicare/Medicaid enrollment by contacting healthcare providers offices and serving as a patient advocate
- Received multiple Stand Out awards from coworkers after being recognized for supporting colleagues
- Utilized empathy when working with clients to best understand their situations and provided tailored support
- Educated customers on disease management programs and made recommendations on healthy living programs
Auto Express
State Farm
, Remote
02.2022 - 04.2022
- Responded to inbound calls and placed outbound calls to review multiple perspectives of vehicle accidents, gathering pertinent information regarding the incident, such as location and a detailed description of the event
- Reviewed coverage and determined causes for loss while establishing simple liability
- Leveraged knowledge of state-by-state laws and event details to make determinations concerning liable parties
- Contacted other insurance agencies to confirm parties at fault and initiate claims process; escalated cases to second-tier departments in the event determinations were unclear or fell outside of assigned authority
- Arranged towing for disabled vehicles and scheduled inspections to assess damage and determine pre-accident value
- Consulted with clients to explain the claims process, manage expectations, and inform them of their rights
- Reviewed reimbursement laws for special conditions regarding car seats
- Set up rental vehicle and direct billing, reviewing policy exceptions and verifying estimated repair times with shops
- Coordinated with auto paint and body shops to discuss estimates and supplements; issued payments for vehicle repairs
- Maintained detailed file notes and effectively managed calendars
- Contracted through Alacrity
Project Manager
CRBR
Reno, NV
05.2021 - 11.2021
- Oversaw the successful execution of restoration or reconstruction projects with average values between $10-$15K
- Established and maintained relationships with clients, insurance adjusters, and claims representatives
- Prepared and maintained project budgets, schedules, and ongoing costs for multiple jobs simultaneously
- Used Xactimate program to create line-item repair agendas and build estimates using 360 scans and property sketches
- Reviewed project estimates with homeowners, creating client contracts and forwarding them to Superintendents
- Ensured projects were performed in a timely and professional manner; updated calendars and contracts if necessary
- Worked closely with project Superintendent to ensure successful completion of assigned jobs
- Visited worksites to verify progress, assist crews in resolving challenges, and answer questions
- Grew SMU understanding and trained others on safety procedures to minimize exposure and risk on projects
- Responsibly used company vehicle on daily basis
Insurance Benefits Verification Representative
CVS Health
11.2020 - 03.2021
- Provided excellent customer service to patients, healthcare professionals and insurance carriers
- Verified insurance coverage for both new and existing patients to process patient prescriptions in a timely manner
- Reviewed and adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines
- Reviewed prespecified claims and claims which exceeded specialist adjudication authority or processing expertise
- Applied medical necessity guidelines to determine coverage and complete eligibility verification
- Handled inquires related to requests for preapprovals/preauthorization's, reconsiderations, or appeals
- Contracted through Brunette Specialists
Quality Control Administrator
Howco Metal Supplier
08.2019 - 11.2020
- Performed regular quality assessments on all incoming materials from vendors for various metals
- Rejected material test reports which failed to meet quality expectations or stamped and verified items for approval
- Utilized computer databases to review products and created templates within Excel to streamline process
- Checked promptness and approval of documents, and ensured their timely turnover rates
- Reviewed Manufacturing Record Books (MRBs) line by line for accuracy
- Reviewed retested items and signed and approved for release when necessary
Quality Control Documentation Specialist
National Oilwell Varco
03.2019 - 05.2019
- Created, stored, amended, processed, submitted for review, and released Mini Manufacturing Record Books (MRBs) for Word Orders and Purchase Orders; validated traceability of MRBs
- Compared documentation to referenced files to ensure they met required specifications
- Compiled required documentation to create MRBs and identified misplaced manufacturing documentation
- Compiled documents not to be included in the Mini MRB Packet for use as supporting documentation
Long Term Substitute Teacher
Head Start
08.2014 - 05.2019
- Followed established classroom schedules and curriculum as planned for the assigned classroom
- Ensured all children were properly supervised and took safety precautions for their well-being
- Facilitated learning activities using supporting materials which addressed the holistic educational needs of students
- Adhered to all agency policies, procedures, and protocol as they related to health, safety, and nutrition
- Maintained classroom management and discipline using developmentally appropriate techniques
- Provided constant supervision of children during indoor and outdoor activities
- Followed the OHS CLASS Methodology and maintained cleanliness of the classroom
Education
Bachelor of Science - Applied Art and Science
Midwestern State University
01.2019
High School Diploma -
South High School
Pueblo, CO01.2014
Skills
- Bilingual (Spanish & English)
- Communication
- Customer Service
- Scheduling & Calendar Management
- Time Management
- Computer Proficiency
- Analytical Thinking
- Flexibility & Adaptability
- Microsoft Office (Word, Excel)
- Client Advocacy
Timeline
Customer Service Advocate
Cigna
04.2022 - 10.2022
Auto Express
State Farm
02.2022 - 04.2022
Project Manager
CRBR
05.2021 - 11.2021
Insurance Benefits Verification Representative
CVS Health
11.2020 - 03.2021
Quality Control Administrator
Howco Metal Supplier
08.2019 - 11.2020
Quality Control Documentation Specialist
National Oilwell Varco
03.2019 - 05.2019
Long Term Substitute Teacher
Head Start
08.2014 - 05.2019
Bachelor of Science - Applied Art and Science
Midwestern State University
High School Diploma -
South High School