RAVEN JACKSON
Winston-Salem
Summary
Detail-oriented insurance and customer service professional with extensive experience in insurance operations and healthcare member services. Expertise in resolving complex billing issues while ensuring compliance and high customer satisfaction. Committed to delivering exceptional customer experiences and maintaining accurate documentation under regulatory guidelines.
Overview
1
1
Certification
12
12
years of professional experience
Work History
Insurance Representative
National General Insurance / Allstate
10.2019 - Current
- Research and resolve customer concerns involving policies, billing, coverage, underwriting, and insurance-related inquiries.
- Resolved billing discrepancies through thorough research, ensuring high customer satisfaction.
- Explained billing statements, payment options, and account balances to customers.
- Processed account adjustments, credits, and payment arrangements in accordance with company policies.
- Reviewed and verified customer account information to ensure billing accuracy.
- Maintained accurate documentation of customer interactions and billing updates.
- Collaborated with internal departments to investigate and resolve account issues, enhancing payment accuracy.
- Managed customer complaint resolution with professionalism and empathy, achieving timely and accurate outcomes.
- Collaborate with underwriting, billing, claims, and service departments to support issue resolution and customer satisfaction.
- Manage a high-volume workload while consistently meeting productivity, quality, and time management expectations.
- Analyze information and identify appropriate solutions while balancing customer needs, compliance standards, and company requirements.
Health Advocate / Case Coordination Support Specialist
UnitedHealthcare
06.2016 - 09.2019
- Facilitated healthcare-related support for members and guided them through service navigation and complaint resolution.
- Coordinated communication among members, providers, nurses, and internal departments to ensure effective service resolution.
- Organized cases for nurse case management teams and coordinated documentation required for clinical review.
- Maintained detailed case documentation and member records, ensuring adherence to quality, compliance, and productivity standards.
- Supported timely case completion through workflow coordination, follow-up activities, and strong time management.
- Researched benefits, claims, eligibility, and authorization issues using multiple systems and resources.
- Handled billing inquiries and resolved customer concerns, achieving first call resolution.
Customer Service Representative
Aon Hewitt
10.2014 - 05.2016
- Educated customers on health savings accounts, guiding them on account balances, contributions, and eligible expenses to enhance their understanding.
- Assisted customers with benefits-related concerns, claim inquiries, and general service questions.
- Researched and resolved complex account and billing issues, ensuring compliance with company policies and maintaining high accuracy.
- Researched issues and collaborated with internal teams to resolve customer concerns efficiently.
- Used conflict resolution skills to support positive customer interactions in a high-volume service environment.
- Documented customer interactions, concerns, and resolutions to ensure accurate records and improve service quality.
- Maintained service quality standards while following company procedures and compliance expectations.
Education
Some College (No Degree) -
Guilford Technical Community College
08-2017
High School Diploma -
Salem Preparatory Academy
Winston-Salem, NC06-2009
Skills
- Insurance Operations
- Account management
- Case Coordination
- Policy & Benefits Review
- Account reconciliation
- Compliance awareness
- HIPAA Compliance
- Research & Analysis
- Workflow Management
- Time Management
- Process Improvement
- Problem Solving
- Cross-functional collaboration
- Customer Complaint Resolution
- Conflict Resolution
- Microsoft Office Suite
Certification
Currently Pursuing Google Project Management Professional Certificate
Timeline
Insurance Representative
National General Insurance / Allstate
10.2019 - Current
Health Advocate / Case Coordination Support Specialist
UnitedHealthcare
06.2016 - 09.2019
Customer Service Representative
Aon Hewitt
10.2014 - 05.2016
Some College (No Degree) -
Guilford Technical Community College
High School Diploma -
Salem Preparatory Academy