Jacquelyn Johnson-Shahin

  • Event Staff
  • Graham, NC, 27253, US
  • Jun 14, 2022
Full time Admin-Clerical Customer Service Entry Level

Personal Summary

Skilled professional with 18 years of experience in healthcare, including 3 years data entry and medical claims processing, and highly productive in a fast-paced environment

• Working knowledge of medical terminology, HCPS, ICD 9(10), and CPT coding systems
• Skilled in effective verbal communication, research, analysis, and problem solving
• Strong keyboarding skills, capable of 9,000 KPH, while highly attentive to detail and accuracy
• Team oriented, with strong ability to work collaboratively
• Dependable and self-motivated, with 5 years of remote office experience

Work Experience

YourCare Health Plan, Provider Service Representative
Mar 2016 - Feb 2021 JACOBSON SOLUTIONS

* Input and approved faxcom precertification requests, or triaged for additional clinical review
* Processed Medicaid managed care claims according to eligibility, benefits, and authorizations
* Investigated coordination of benefits by contacting providers, members, and other insurance plans

Provider Service Representative, BCBS of Arkansas
Feb 2014 - Jan 2015 JACOBSON SOLUTIONS

* Serviced 70+ calls pr day, concerning claim status, denial review, and EOB copies
* Provided assistance with provider portal registration and navigation

Delta Dental of Massachusetts Customer Service Associate
Dec 2010 - Jul 2012 JACOBSON SOLUTIONS

• Researched and responded to customer telephone inquiries, related to benefits, and unpaid claims
• Identified and reported system errors during major system migration
• Met and maintained acceptable production requirements and inquiry response turnaround

Benefit Call Center Representative
Jul 2015 - Mar 2016 CONDUENT

* Verified employee and retiree health plan elections and assisted with coverage related issues
* Analyzed data from Flexible spending account activity and submitted IT ticket for research

Customer Service Professional
Oct 2000 - Oct 2010 BCBS OF NORTH CAROLINA

• Management selected for Provider Education Test (PET) Pilot Program team
• Answered high volume of calls requesting claims payment and detail and plan coverage information
• Responded to email and chat inquiries from health program incentive program members


High School Diploma
Sep 1981 - Jan 1984 Orange High School