Jessica Johnson
Norfolk
Summary
Professional with extensive experience in customer interactions and service solutions. Expertise in conflict resolution and effective communication, leading to high levels of customer satisfaction and loyalty. Proven track record of collaborating with teams to adapt to changing needs and achieve organizational goals through efficient service delivery.
Overview
12
12
years of professional experience
Work History
LEAD RECEPTIONISTS
Verdi eye specialists
09.2024 - Current
- Perform the necessary administrative responsibilities needed to create a smooth check-in/out experience for patients
- Provide exceptional customer service during every patient encounter (in person or via phone)
- Display a professional attitude, greet patients promptly with a smile, and thank them when they leave
- Answer phones (both external and internal); assure prompt, courteous service at all times
- Practice urgency at all times with patient’s time, as well as doctor’s time and schedule
- Double check insurance authorizations to ensure completion and build accurate flow sheets
- Knowledge of common fees charged for common visits
- Check out patients and collect correct payments
- Manage patient flow in the office
- Complete daily reconciliations / close day / countdown cash drawer
- Comply with all company policies and procedures including HIPAA
- General office duties and cleaning to be assigned by manager
LEAD RECEPTIONISTS
Verdi eye specialists
09.2024 - Current
- Perform the necessary administrative responsibilities needed to create a smooth check-in/out experience for patients
- Provide exceptional customer service during every patient encounter (in person or via phone)
- Display a professional attitude, greet patients promptly with a smile, and thank them when they leave
- Answer phones (both external and internal); assure prompt, courteous service at all times
- Practice urgency at all times with patient’s time, as well as doctor’s time and schedule
- Double check insurance authorizations to ensure completion and build accurate flow sheets
- Knowledge of common fees charged for common visits
- Check out patients and collect correct payments
- Manage patient flow in the office
- Complete daily reconciliations / close day / countdown cash drawer
- Comply with all company policies and procedures including HIPAA
- General office duties and cleaning to be assigned by manager
HEALTH CONCIERGE
AETNA, CVS HEALTH COMPANY
07.2022 - 04.2023
- Build relationships with customers, patients and caregivers
- Assist customers by helping them navigate healthcare services and products
- Promote CVS Health consumer facing healthcare programs/initiatives and Health Hub offerings
- Act as Product Resource Assistant for Home Health Care (HHC)
- Adhere to professional practice standards
- Process and submit insurance claims daily
- Monitor and follow-up on outstanding claims
- Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors
- Triages resulting rework to appropriate staff.
- Documents and tracks contacts with members, providers and plan sponsors
- The CSR guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.
- Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health
- Taking accountability to fully understand the member s needs by building a trusting and caring relationship with the member. Anticipates customer needs
- Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
- Uses customer service threshold framework to make financial decisions to resolve member issues
- Explains member's rights and responsibilities in accordance with contract.
- Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system
- Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues
- Responds to requests received from Aetna's Law Document Center regarding litigation; lawsuits
- Handles extensive file review requests. Assists in preparation of complaint trend reports
- Assists in compiling claim data for customer audits.
- Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals
- Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management
- Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
- Performs financial data maintenance as necessary.
- Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received
HEALTH CONCIERGE
AETNA, CVS HEALTH COMPANY
07.2022 - 04.2023
- Build relationships with customers, patients and caregivers
- Assist customers by helping them navigate healthcare services and products
- Promote CVS Health consumer facing healthcare programs/initiatives and Health Hub offerings
- Act as Product Resource Assistant for Home Health Care (HHC)
- Adhere to professional practice standards
- Process and submit insurance claims daily
- Monitor and follow-up on outstanding claims
- Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors
- Triages resulting rework to appropriate staff.
- Documents and tracks contacts with members, providers and plan sponsors
- The CSR guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.
- Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health
- Taking accountability to fully understand the member s needs by building a trusting and caring relationship with the member. Anticipates customer needs
- Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
- Uses customer service threshold framework to make financial decisions to resolve member issues
- Explains member's rights and responsibilities in accordance with contract.
- Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system
- Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues
- Responds to requests received from Aetna's Law Document Center regarding litigation; lawsuits
- Handles extensive file review requests. Assists in preparation of complaint trend reports
- Assists in compiling claim data for customer audits.
- Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals
- Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management
- Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
- Performs financial data maintenance as necessary.
- Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received
MEMBER SERVICE REPRESENTATIVE
KELLY CONNECT
08.2021 - 01.2022
- May initiate outgoing calls, providing customer service to plan members by answering benefit questions and resolving issues.
- Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
- Ensures accuracy and timeliness of the membership and billing function.
- Responds to inquiries concerning enrollment processes, maintain enrollment database, and may order identification cards.
- Determines eligibility and applies contract language for each case assigned.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
- Researches and analyzes data to address operational challenges and customer service issues.
- Provides external and internal customers with requested information.
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
MEMBER SERVICE REPRESENTATIVE
KELLY CONNECT
08.2021 - 01.2022
- May initiate outgoing calls, providing customer service to plan members by answering benefit questions and resolving issues.
- Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
- Ensures accuracy and timeliness of the membership and billing function.
- Responds to inquiries concerning enrollment processes, maintain enrollment database, and may order identification cards.
- Determines eligibility and applies contract language for each case assigned.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
- Researches and analyzes data to address operational challenges and customer service issues.
- Provides external and internal customers with requested information.
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
PATIENT ACCESS COORDINATOR
ORTHOVIRGINIA
12.2019 - 09.2020
- The Patient Access Coordinator position is responsible for assisting patients and referral sources with scheduling of appointments. Provides exceptional patient service by answering, responding, and routing a high volume of incoming calls from patients, physicians, hospitals, staff and other callers. Adheres to internal protocols to ensure consistency and quality service. Obtains accurate demographic information, and routes patient related questions to appropriate area.
- Manages telephone calls as well as patient inquiries via mail or fax; return patient phone concierge, Website, MyChart and CIH appointment requests in a timely manner.
- Answers phones appropriately and professionally, providing excellent customer service.
- Clarifies information needed by the caller and determines best course of action to meet the customer's needs.
- Effectively communicates with physicians, patients, and other professionals and returns phone calls promptly.
- Schedules patient's appointments in accordance with internal guidelines and physician appointment scheduling protocols.
- Collects and enters patient's demographics in the system completely and accurately.
- Verifies patient's insurance information and confirms that Ortho Virginia participates with their insurance plan.
- Verifies any information necessary in preparation for office visit (e.g. if the patient has seen another physician for the same problem, if x-rays are available, etc.).
- Direct patient calls regarding medical inquires to the appropriate resource.
- Assist with Epic Work Queues as appropriate/assigned.
- Send out appointment reminder card/patient packet if requested.
- Performs other duties as assigned.
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
PATIENT ACCESS COORDINATOR
ORTHOVIRGINIA
12.2019 - 09.2020
- The Patient Access Coordinator position is responsible for assisting patients and referral sources with scheduling of appointments. Provides exceptional patient service by answering, responding, and routing a high volume of incoming calls from patients, physicians, hospitals, staff and other callers. Adheres to internal protocols to ensure consistency and quality service. Obtains accurate demographic information, and routes patient related questions to appropriate area.
- Manages telephone calls as well as patient inquiries via mail or fax; return patient phone concierge, Website, MyChart and CIH appointment requests in a timely manner.
- Answers phones appropriately and professionally, providing excellent customer service.
- Clarifies information needed by the caller and determines best course of action to meet the customer's needs.
- Effectively communicates with physicians, patients, and other professionals and returns phone calls promptly.
- Schedules patient's appointments in accordance with internal guidelines and physician appointment scheduling protocols.
- Collects and enters patient's demographics in the system completely and accurately.
- Verifies patient's insurance information and confirms that Ortho Virginia participates with their insurance plan.
- Verifies any information necessary in preparation for office visit (e.g. if the patient has seen another physician for the same problem, if x-rays are available, etc.).
- Direct patient calls regarding medical inquires to the appropriate resource.
- Assist with Epic Work Queues as appropriate/assigned.
- Send out appointment reminder card/patient packet if requested.
- Performs other duties as assigned.
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
MEDICAL CALL CENTER REPRESENTATIVE/ FRONT DESK RECEPTIONIST
CAPITAL AREA HEALTH NETWORK
08.2017 - 12.2019
- Responsible for answering phone calls for Capital Area Health Network, specifically the medical department, scheduling appointments, leaving messages for providers and other staff members, responding to general inquiries and otherwise providing solutions to callers’ questions and concerns.
- Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed.
- Understanding and striving to meet or exceed call center metrics while providing excellent consistent customer service.
- Ability to read, write, type 25 WPM, follow oral and written instructions, and communicate effectively.
- Experience working in a high call volume environment is highly desirable (50 - 80 calls per day on average).
- Communicating information about CAHN billing policies, including insurable and non-insurable charges, as needed;
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
- Perform the duties of a Front Desk Representative
- Attend morning huddle; no matter the location
- Greet patients upon arrival; sign them in; verify that all information in the system is correct
- Obtain identification data and verify that it is correct in the system
- Verify Insurance card matches what is in the system
- Assist uninsured or underinsured self-pay patients
- Follows up on all missed or cancelled appointments
- Explain to patients the Medical Center’s system of care and all programs that are available to all new patients
- Educate the patients about the importance of making an appointment
- Explain to the patients their responsibility to pay at the time of service and explain our minimum fee, as well as all information to bring with them to their visit: insurance card, co-pay, photo ID, any medications they are taking, etc.
- Maintain a pleasant dialogue with all persons registering
- Ensure quality customer service is being provided to all patients, clients and vendors
- Develop, maintain, and present reports detailing the status and progress of the Patient Services Representative Division
- Call patients to assign follow up visit after their Tele-visit
- Generates and balances end of day report for payments
- Verify supplies that are needed and complete supply checklist
- Submits their assignment checklist daily, to the Team Lead for review
- Performs other duties as assigned
MEDICAL CALL CENTER REPRESENTATIVE/ FRONT DESK RECEPTIONIST
CAPITAL AREA HEALTH NETWORK
08.2017 - 12.2019
- Responsible for answering phone calls for Capital Area Health Network, specifically the medical department, scheduling appointments, leaving messages for providers and other staff members, responding to general inquiries and otherwise providing solutions to callers’ questions and concerns.
- Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed.
- Understanding and striving to meet or exceed call center metrics while providing excellent consistent customer service.
- Ability to read, write, type 25 WPM, follow oral and written instructions, and communicate effectively.
- Experience working in a high call volume environment is highly desirable (50 - 80 calls per day on average).
- Communicating information about CAHN billing policies, including insurable and non-insurable charges, as needed;
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
- Perform the duties of a Front Desk Representative
- Attend morning huddle; no matter the location
- Greet patients upon arrival; sign them in; verify that all information in the system is correct
- Obtain identification data and verify that it is correct in the system
- Verify Insurance card matches what is in the system
- Assist uninsured or underinsured self-pay patients
- Follows up on all missed or cancelled appointments
- Explain to patients the Medical Center’s system of care and all programs that are available to all new patients
- Educate the patients about the importance of making an appointment
- Explain to the patients their responsibility to pay at the time of service and explain our minimum fee, as well as all information to bring with them to their visit: insurance card, co-pay, photo ID, any medications they are taking, etc.
- Maintain a pleasant dialogue with all persons registering
- Ensure quality customer service is being provided to all patients, clients and vendors
- Develop, maintain, and present reports detailing the status and progress of the Patient Services Representative Division
- Call patients to assign follow up visit after their Tele-visit
- Generates and balances end of day report for payments
- Verify supplies that are needed and complete supply checklist
- Submits their assignment checklist daily, to the Team Lead for review
- Performs other duties as assigned
PHARMACY HELP DESK REPRESENTATIVE
CONCENTRIX
06.2017 - 12.2017
- Answer pharmacy calls pertaining to Third Party billing, provide assistance to retail pharmacies ensuring issues are identified and resolved in a timely manner.
- Experience working in a high call volume environment is highly desirable (30 - 40 calls per day on average)
- Determine whether system problems are software or hardware related and escalate to the appropriate department.
- Log calls into a proprietary call management system for tracking and reporting purposes.
- Serve as a liaison between pharmacies and insurance plan or claims processors to resolve prescription problems.
- Worked on claims regarding prior authorizations, Medicare billing, and overriding claims
- Detailed knowledge of procedures and policy
- Experience in validating patients' insurance data
- Knowledge of insurance policy
- Good verification skills
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
PHARMACY HELP DESK REPRESENTATIVE
CONCENTRIX
06.2017 - 12.2017
- Answer pharmacy calls pertaining to Third Party billing, provide assistance to retail pharmacies ensuring issues are identified and resolved in a timely manner.
- Experience working in a high call volume environment is highly desirable (30 - 40 calls per day on average)
- Determine whether system problems are software or hardware related and escalate to the appropriate department.
- Log calls into a proprietary call management system for tracking and reporting purposes.
- Serve as a liaison between pharmacies and insurance plan or claims processors to resolve prescription problems.
- Worked on claims regarding prior authorizations, Medicare billing, and overriding claims
- Detailed knowledge of procedures and policy
- Experience in validating patients' insurance data
- Knowledge of insurance policy
- Good verification skills
- Maintains HIPAA privacy and best practices when handling patient Protected Health Information (PHI).
SALES ASSOCIATE
MACYS
04.2016 - 09.2016
- Provide high quality customer service to optimize customer purchasing and payment process.
- Open and close registers, performing task such as counting money, separating charge slips, coupons, vouchers, balancing cash drawers, and making deposits.
- Recommend, select, and help locate or obtain merchandise based on customer needs or desires.
- Place special orders or call other stores to find desired items.
- Compute sales prices, total purchases and receive and process cash or credit payment
SALES ASSOCIATE
MACYS
04.2016 - 09.2016
- Provide high quality customer service to optimize customer purchasing and payment process.
- Open and close registers, performing task such as counting money, separating charge slips, coupons, vouchers, balancing cash drawers, and making deposits.
- Recommend, select, and help locate or obtain merchandise based on customer needs or desires.
- Place special orders or call other stores to find desired items.
- Compute sales prices, total purchases and receive and process cash or credit payment
TEAM MEMBER
BUFFALO WILD WINGS
03.2015 - 10.2015
- Open, set up, and closed the establishment
- Maintain clean and orderly dining area
- Input customer orders into the system and delivered to tables
- Stocked counter storage areas and customer tabletop dispensers
- Handled customer service issues and referred more in-depth issues to management per protocol
- Communicated well and used strong interpersonal skills to establish positive relationships with guest and co-workers.
TEAM MEMBER
BUFFALO WILD WINGS
03.2015 - 10.2015
- Open, set up, and closed the establishment
- Maintain clean and orderly dining area
- Input customer orders into the system and delivered to tables
- Stocked counter storage areas and customer tabletop dispensers
- Handled customer service issues and referred more in-depth issues to management per protocol
- Communicated well and used strong interpersonal skills to establish positive relationships with guest and co-workers.
WAREHOUSE ASSOCIATE
VIRGINIA LINEN
08.2014 - 03.2015
- Responsible for safely and accurately loading and unloading customer garments and bulk products into industrial washers and dryers using washroom equipment to set appropriate wash and dry parameters based on product type.
- The Washroom Operator coordinates transfers between washers and dryers and monitors the proper functioning of washroom equipment.
- Warehouse Associates are expected to maintain the cleanliness of their work area and to meet or exceed a standard for quantity and quality of work.
- Washing, drying, and ironing sheets, towel, and bedding
- Load machines with items
- Folding items before bagging them
- Sorting items according to color, size, type, and fabric
WAREHOUSE ASSOCIATE
VIRGINIA LINEN
08.2014 - 03.2015
- Responsible for safely and accurately loading and unloading customer garments and bulk products into industrial washers and dryers using washroom equipment to set appropriate wash and dry parameters based on product type.
- The Washroom Operator coordinates transfers between washers and dryers and monitors the proper functioning of washroom equipment.
- Warehouse Associates are expected to maintain the cleanliness of their work area and to meet or exceed a standard for quantity and quality of work.
- Washing, drying, and ironing sheets, towel, and bedding
- Load machines with items
- Folding items before bagging them
- Sorting items according to color, size, type, and fabric
SALES ASSOCIATE
AMERICAN EAGLE OUTFITTERS
07.2013 - 11.2014
- Open and close registers, performing task such as counting money, separating charge slips, coupons, vouchers, balancing cash drawers, and making deposits.
- Recommend, select, and help locate or obtain merchandise based on customer needs or desires.
- Place special orders or call other stores to find desired items.
- Compute sales prices, total purchases and receive and process cash or credit payment
- Assisted customers with locating items
- Responsible for resolving all customer complaints
- Maximized sales transactions
- Handled returns and exchanges
- Restocked shelves
- Kept store clean
SALES ASSOCIATE
AMERICAN EAGLE OUTFITTERS
07.2013 - 11.2014
- Open and close registers, performing task such as counting money, separating charge slips, coupons, vouchers, balancing cash drawers, and making deposits.
- Recommend, select, and help locate or obtain merchandise based on customer needs or desires.
- Place special orders or call other stores to find desired items.
- Compute sales prices, total purchases and receive and process cash or credit payment
- Assisted customers with locating items
- Responsible for resolving all customer complaints
- Maximized sales transactions
- Handled returns and exchanges
- Restocked shelves
- Kept store clean
Education
High School Diploma - undefined
HOPEWELL HIGH SCHOOL
HOPEWELL, VA06.2013
Skills
- Customer service
- Managing patient inquiries
- Scheduling appointments
- Navigating complex insurance policies
- Providing empathetic support
- Compliance with HIPAA regulations
Timeline
LEAD RECEPTIONISTS
Verdi eye specialists
09.2024 - Current
LEAD RECEPTIONISTS
Verdi eye specialists
09.2024 - Current
HEALTH CONCIERGE
AETNA, CVS HEALTH COMPANY
07.2022 - 04.2023
HEALTH CONCIERGE
AETNA, CVS HEALTH COMPANY
07.2022 - 04.2023
MEMBER SERVICE REPRESENTATIVE
KELLY CONNECT
08.2021 - 01.2022
MEMBER SERVICE REPRESENTATIVE
KELLY CONNECT
08.2021 - 01.2022
PATIENT ACCESS COORDINATOR
ORTHOVIRGINIA
12.2019 - 09.2020
PATIENT ACCESS COORDINATOR
ORTHOVIRGINIA
12.2019 - 09.2020
MEDICAL CALL CENTER REPRESENTATIVE/ FRONT DESK RECEPTIONIST
CAPITAL AREA HEALTH NETWORK
08.2017 - 12.2019
MEDICAL CALL CENTER REPRESENTATIVE/ FRONT DESK RECEPTIONIST
CAPITAL AREA HEALTH NETWORK
08.2017 - 12.2019
PHARMACY HELP DESK REPRESENTATIVE
CONCENTRIX
06.2017 - 12.2017
PHARMACY HELP DESK REPRESENTATIVE
CONCENTRIX
06.2017 - 12.2017
SALES ASSOCIATE
MACYS
04.2016 - 09.2016
SALES ASSOCIATE
MACYS
04.2016 - 09.2016
TEAM MEMBER
BUFFALO WILD WINGS
03.2015 - 10.2015
TEAM MEMBER
BUFFALO WILD WINGS
03.2015 - 10.2015
WAREHOUSE ASSOCIATE
VIRGINIA LINEN
08.2014 - 03.2015
WAREHOUSE ASSOCIATE
VIRGINIA LINEN
08.2014 - 03.2015
SALES ASSOCIATE
AMERICAN EAGLE OUTFITTERS
07.2013 - 11.2014
SALES ASSOCIATE
AMERICAN EAGLE OUTFITTERS
07.2013 - 11.2014
High School Diploma - undefined
HOPEWELL HIGH SCHOOL