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Q&A With jamise jackson

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jamise jackson
Analyst, Molina Healthcare
Location: fort worth, TX United States
Joined: Apr 4th, 2002
About   (request update)
Current Whereabouts:
softball
Education   (request update)
Howard University class of 2005
Undergrad Major: Political Science
Claim To Fame:
chain of restaurants, hair salons, and law firms
Most Memorable Moment:
freshman year football homecoming
Experience
I currently work with Molina Healthcare as Analyst
I have 20 years of experience working in the industry.
Specialist, Appeals & Grievances | Molina Healthcare Inc
From March 2021 to Current • 5 year(s)
 Analyzed and resolved fraud reports, appeals, grievances and complaints to meet Medicare and Medicaid standards. Completed claims research, CPT/ICD-10 code validation and collaborated with various departments to ensure member satisfaction.
Benefits Coding/Configuration Rep II | CVS Health
From August 2018 to March 2021 • 3 year(s)
 Analyzed and implemented benefit plan setups for Employer Third Party Administrator Commercial business. Validated coding accuracy and collaborated with internal and external partners to ensure client satisfaction.
Claims Processing Rep II | HUMANA
From July 2014 to August 2018 • 4 year(s)
 Processed 150-250 Medicare/Medicaid claims daily with 100% quality metrics. Conducted deep dive research and root cause analysis for medical claims requiring clinical review.
Employee Service Rep II | ADP/SHPS
From September 2010 to July 2014 • 4 year(s)
 Provided billing and enrollment support, outbound/inbound customer support for Medicare, Commercial, Employer, and Managed Care accounts. Received WOW call award for first call resolution.
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Be blessed
Tagged by Ralph White on 04/20/2025  
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