VANESSA JACKSON
Frisco,TX
Summary
Detail-oriented Medical Benefits Verification and Prior Authorization Specialist with over 5 years of experience optimizing insurance workflows for commercial and government payers. Streamlines coverage verification, authorization processes, and appeals management to enhance patient access to care and minimize claim denials. Skilled in utilizing payer portals, EMR systems, and collaborating effectively with clinic teams and billing representatives.
Overview
13
13
years of professional experience
Work History
Provider Customer Service Rep
Curative Health Insurance
Frisco, TX
04.2025 - Current
- Clarified health plan coverage and communicated benefit details to enhance customer understanding.
- Answered inbound calls and emails to resolve customer inquiries.
- Protected confidentiality while addressing complaints quickly.
- Documented customer interactions and identified next actions to streamline follow-up processes.
- Completed outreach and supported appeals process.
- Updated internal databases with customer detail changes, comments, and complaints.
- Collaborated with internal teams to resolve complex claim issues, ensuring timely resolutions for customers.
Medical Insurance Verification Specialist
McKesson
Frisco, TX
11.2024 - 02.2025
- Verified patient insurance eligibility before scheduling procedures before procedures or appointment scheduling.
- Coordinated with insurance companies to resolve verification issues, ensuring timely patient care.
- Communicated with insurance companies to clarify payment benefits and gather policy and payment benefit details for patients.
- Entered data into the EMR system to document payer authorization requirements and coverage limits.
- Collaborated with teams to enhance customer experience and streamline verification processes.
- Analyzed data to identify and implement process improvements in insurance verification.
- Carried out recommendations from analysis through implementation.
- Worked with leadership on priority projects.
- Used electronic health record systems for data entry and record management.
Medical Insurance Verification Authorization Scheduling Specialist
Crystal Home Health Care
02.2020 - 04.2024
- Verified patient insurance eligibility and benefits across commercial and government payers before next-day services to identify copays, deductibles, and coinsurance.
- Reviewed payer authorization portals to confirm prior authorization requirements and complete next steps.
- Prioritized and sorted time-sensitive workloads by appointment timing, ensuring the earliest next-day appointments were verified and addressed first.
- Conducted thorough checks for missing information, payer requirements, and appeal steps to support denial prevention before service delivery.
- Recorded benefit verification and authorization details in system portals and provided clear daily handoffs to daytime BVA teams for items needing clinic or payer follow-up during normal business hours.
- Worked across BVA, scheduling, billing, and accounts receivable teams to support accurate workflows and escalate trends in late-added appointments, benefit issues, or authorization barriers.
- Showed independent judgment, strong attention to detail, high reliability, and personal accountability while managing priorities with limited real-time supervision.
Telemetry Technician
McLaren Medical Center
Flint, MI
02.2014 - 08.2023
- Analyzed data to identify trends and support actionable process improvements.
- Completed projects from analysis through implementation.
- Partnered with leadership to shape project direction and align objectives.
- Organized daily tasks efficiently to maximize productivity while ensuring quality standards were met.
- Collaborated with teams to enhance customer experience through targeted initiatives.
Education
Associate of Healthcare Administration -
Baker College
Flint, MI06-2014
CompTIA A+ -
Per Scholas
Dallas, TXSkills
- Payer portals and workflows understanding
- Denial management and appeals handling
- Healthcare terminology and policies familiarity
- Customer experience enhancement
- Effective communication
- Cross-functional collaboration
- Project management
- Process improvement
- Data analysis expertise
- Analytical thinking
- Problem-solving abilities
- Microsoft Office suite
- Independent decision-making capabilities
- Leadership skills
- Independent decision-making capabilities
Personal Information
Title: Senior Associate, Customer Experience, Benefit and Insurance Verification
Timeline
Provider Customer Service Rep
Curative Health Insurance
04.2025 - Current
Medical Insurance Verification Specialist
McKesson
11.2024 - 02.2025
Medical Insurance Verification Authorization Scheduling Specialist
Crystal Home Health Care
02.2020 - 04.2024
Telemetry Technician
McLaren Medical Center
02.2014 - 08.2023
Associate of Healthcare Administration -
Baker College
CompTIA A+ -
Per Scholas