Jasmine Fleming
Norfolk
Summary
Results-driven Customer Service professional with a strong emphasis on team collaboration and adaptability, providing reliable support in dynamic environments. Adept in benefits administration, compliance, and communication, with a proactive approach to problem-solving and efficiency. Recognized for consistently maintaining high standards and achieving impactful outcomes in all endeavors.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Billing Customer Service Representative
Sentara Healthcare
07.2025 - Current
- Resolve billing inquiries, ensuring accurate account information for customers.
- Process payment transactions efficiently, enhancing customer satisfaction.
- Coordinate with internal departments to address and resolve billing discrepancies.
- Monitored account statuses, proactively identifying issues before they escalated.
- Updated customer records with accurate billing information, preventing future disputes and delays in payment processing.
- Ensure compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Strengthen security measures for sensitive customer information by adhering to strict guidelines and protocols.
- Provide exceptional customer service by resolving inquiries related to payments, account balances, and transaction discrepancies.
- Follow up with overdue payments and payment plans from clients to establish good cash flow.
- Work effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Self-motivated, with a strong sense of personal responsibility.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
COB Verification Specialist II
Elevance Health
04.2021 - 02.2025
- Verified and maintained accurate insurance coverage and COB information to ensure proper claim adjudication and prevent overpayment or duplication of benefits.
- Handled ancillary programs for health, dental, vision, life, disability, and accident insurance.
- Investigated and resolved discrepancies in insurance coverage by contacting members, providers, and other insurance carriers.
- Coordinated benefits for members with multiple insurance plans to ensure compliance with federal and state regulations, including CMS guidelines.
- Resolved an average of 50+ COB cases per day while maintaining a 98% accuracy rates via phone calls, emails and faxes on a daily basis.
- Completed urgent inventory tasks within required turnaround times for various clients and vendors.
- Processed COB updates in internal systems while maintaining a high level of data integrity and confidentiality.
- Assisted with special state projects, including CMS Audits, state and provider complaints and CAV enhancement specific projects.
- Improved claim processing accuracy by 25% through thorough investigation and timely COB updates and Reduced claims denials due to COB errors by 20% through proactive member outreach and database updates.
- Verified Insurance benefits for different Health plans including Medicare, Medicaid, Commercial etc.
OTC Medicare Member Representative
Anthem, Inc.
12.2020 - 04.2021
- Assisted Medicare and Medicaid members in understanding and utilizing their Over-the-Counter (OTC) benefits for eligible health products.
- Processed OTC product orders via phone, ensuring accuracy in product selection, shipping details, and member eligibility.
- Managed high volume call center environment, which metric based results.
- Provided personalized support to members, helping them navigate OTC catalogs, online ordering platforms, and plan allowances.
- Responded to an average of 50+ inbound calls per day and, Maintained a 95%+ member satisfaction rating through clear communication, timely issue resolution, and proactive assistance.
- Resolved member concerns related to order delays, incorrect shipments, benefit balances, and product availability.
- Verified member eligibility, remaining benefit balance, and product limits per plan guidelines before order placement.
Medicare Application Representative
Qualfon
09.2020 - 12.2020
- Assisted beneficiaries with completing and submitting Medicare enrollment applications, ensuring all required documentation and signatures were included.
- Calculated premiums and established payment methods for clients profiles.
- Conducted interviews with applicants explaining benefits process and which plans were available.
- Verified applicant eligibility for Medicare Parts A, B, C, and D based on age, disability status, and income level.
- Processed an average of 30–50 Medicare applications daily while maintaining accuracy and turnaround time standards.
- Ensured all application procedures complied with CMS (Centers for Medicare & Medicaid Services) rules and internal policy standards.
- Guided Medicare-eligible individuals through the application process by answering questions, clarifying plan options, and providing next steps.
- Navigated multiple internal and CMS systems to input data, track application status, and escalate complex cases when necessary.
- Reviewed and corrected application errors or missing information to prevent enrollment delays or denials.
Enrollment Specialist
CONDUENT
12.2019 - 03.2020
- Verified applicant eligibility, supporting documentation, and plan selection before finalizing enrollment.
- Assisted patients in enrolling in prescription assistance programs, ensuring access to essential medications at low or no cost.
- Recorded patients demographic information and, collected any insurance card information.
- Handled an average of 40–60 calls or cases daily, maintaining a customer satisfaction score of 95% or higher.
- Communicated with patients, providers, and pharmacies to coordinate medication fulfillment and confirm eligibility requirements.
- Managed accurate recordkeeping of patient information and application documents, ensuring compliance with regulations.
- Tracked and managed case files from initial inquiry to medication approval, ensuring timely follow-up and communication.
Direct Support Professional Caregiver
ST. MARY'S HOME FOR CHILDREN
11.2018 - 04.2019
- Assisted children with intellectual and developmental disabilities in daily activities, including bathing, grooming, dressing, and meal preparation.
- Implemented individualized service plans (ISPs) and behavioral strategies to support clients in achieving personal goals.
- Accurately documented daily progress notes, behavioral incidents, and medication administration in accordance with agency and state guidelines.
- Promoted client independence by teaching life skills such as budgeting, cooking, medication reminders, and personal hygiene.
- Developed rapport with the children to create safe and trusting, and fun environment for care
- Monitored and redirected behaviors using de-escalation techniques and trauma-informed care practices.
- Maintained confidentiality and compliance with HIPAA and other regulatory standards.
- Participated in staff training on CPR, first aid, crisis intervention, and person-centered planning.
- Reduced incident reports by 20% through consistent implementation of behavioral support plans and positive reinforcement.
Customer Service Specialist
UPS
11.2018 - 01.2019
- Provided professional and efficient support to customers regarding package tracking, shipping options, delivery times, and billing inquiries.
- Resolved shipping issues, including lost or delayed packages, damaged goods, and address corrections, while maintaining a calm and helpful demeanor.
- Handled 50+ inbound call inquiries daily, consistently achieving high customer satisfaction scores.
- Collaborated with warehouse and delivery teams to troubleshoot and resolve shipping delays and delivery exceptions.
- Accurately entered customer information and package data into UPS systems such as WorldShip, DIAD, and CRM platforms.
- Handled sensitive customer and billing data with confidentiality and accuracy.
- Achieved a 95%+ first-call resolution rate by using product knowledge and system tools to solve shipping-related issues.
- Processed claims for missing merchandise during deliveries.
Claims Support Representative
SUTHERLAND GLOBAL SERVICES
02.2018 - 08.2018
- Assessed caller accounts to determine Short-Term/Long-Term Disability claim benefits, identify service needs and resolve issues
- Assisted in processing new claims submissions, follow-ups, and updates in accordance with company policies and regulatory standards.
- Guided Customers through filing a claim, requesting information on an existing claim, and making any changes or updates
- Monitored claim statuses and ensured timely communication of updates to claimants, adjusters, and providers.
- Responded to incoming calls and inquiries from policyholders, providers, and third parties regarding the status of claims, coverage, and required documentation.
- Accurately input and updated claims data in claims management systems such as Guidewire, Epic, Facets, or proprietary platforms.
- Maintained organized electronic and paper records to support audits, legal reviews, and quality control.
- Prepared and submitted standard letters and communications regarding claim determinations, delays, or required follow-up.
- Processed and supported 50+ claims per day while maintaining accuracy and meeting daily productivity goals.
Apple Technical Support Advisor
IBEX Global
08.2017 - 02.2018
- Delivered comprehensive support for all technical problems related to Apple hardware and software.
- Led training efforts to empower personnel to resolve technical issues without submitting support tickets, reducing service calls.
- Improved first-call resolution rates by developing comprehensive troubleshooting guides and knowledge base articles.
- Enhanced client satisfaction by providing timely and accurate technical support.
Medical Claims Processor
DOMA TECHNOLOGIES LLC
06.2016 - 06.2017
- Analyzed & identified various claims issues before completion
- Contacted healthcare providers to confirm appointment statuses for claims purpose
- Ensured claims were billed and paid correctly.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology, insurance coding and other procedures
- Based the payment or denials of medical claims upon well-established criteria for claims processing
Education
Human Resources -
Tidewater Community College
Norfolk, VA01.2016
High School Diploma -
Maury High School
Norfolk, VA06.2014
Skills
- Customer service expertise
- Benefits Coordinating
- Detail-oriented analysis
- Prioritization and scheduling
- Analytical problem-solving
- Excellent Verbal and Written Communication
- Effective organizational skills
- Multitasking in High-Volume Environments
- Efficient claims management
- HRIS management
- Carrier relationship management
- Expertise in ERISA, HIPAA, and ACA compliance
- Adaptability to change
- Proficient in Microsoft products
- Proficient in ICD-10 classification
- Troubleshooting and technical guidance
- EOB analysis
- Collaborative teamwork
- Insurance approval coordination
- Medicaid and Medicare enrollment expertise
- Benefits administration
- Data entry proficiency
- Experience in payroll processing
- Regulatory monitoring
- Open enrollment
- Program administration
Certification
- CPR Certification
- Six Sigma Yellow Belt, Elevance Health - 2024
Personal Information
Authorized To Work: US for any employer
Timeline
Billing Customer Service Representative
Sentara Healthcare
07.2025 - Current
COB Verification Specialist II
Elevance Health
04.2021 - 02.2025
OTC Medicare Member Representative
Anthem, Inc.
12.2020 - 04.2021
Medicare Application Representative
Qualfon
09.2020 - 12.2020
Enrollment Specialist
CONDUENT
12.2019 - 03.2020
Direct Support Professional Caregiver
ST. MARY'S HOME FOR CHILDREN
11.2018 - 04.2019
Customer Service Specialist
UPS
11.2018 - 01.2019
Claims Support Representative
SUTHERLAND GLOBAL SERVICES
02.2018 - 08.2018
Apple Technical Support Advisor
IBEX Global
08.2017 - 02.2018
Medical Claims Processor
DOMA TECHNOLOGIES LLC
06.2016 - 06.2017
Human Resources -
Tidewater Community College
High School Diploma -
Maury High School