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JESSICA MCQUIRE

@jessicamcquire

Experienced Claims Specialist with a decade in healthcare claims processing.

United States
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What I'm looking for

I am seeking a role that offers opportunities for growth and leadership in claims management.

I am an experienced Claims Specialist with over 10 years of expertise in claims processing, prior authorizations, medical billing, and regulatory compliance within the healthcare and pharmacy sectors. My career has been dedicated to optimizing workflows and ensuring timely and accurate claim resolutions. I excel in claims adjudication, reimbursement processing, and compliance enforcement, collaborating effectively with providers, insurance companies, and cross-functional teams.

In my current role as a Claims Intake Advocate at Cigna Supplemental, I process incoming medical and pharmacy claims, ensuring accuracy and compliance while educating clients on insurance coverage and prior authorization procedures. My previous experience includes leading process improvement initiatives and managing claims-related projects, where I utilized tools like Microsoft Project, Asana, and Jira to enhance workflow efficiency. I have a proven track record of resolving claims discrepancies and improving processing efficiency, which has been instrumental in my success in the field.

Experience

Work history, roles, and key accomplishments

CS
Current

Claims Intake Advocate

Cigna Supplemental

May 2023 - Present (2 years 2 months)

Processed incoming medical and pharmacy claims, ensuring accuracy, compliance, and timely reimbursement. Educated clients on insurance coverage, policy benefits, and prior authorization procedures.

E(

Eligibility Advocate/Billing Specialist

Express Scripts (Accredo)

Sep 2021 - May 2023 (1 year 8 months)

Processed pharmacy claims and reimbursement verification to ensure accurate payments. Followed up on prior authorization requests and provided status updates to providers and patients.

RS

Medical Claims Collector /Provider Relations

Recruiting Solutions

May 2012 - Sep 2021 (9 years 4 months)

Investigated and resolved claims authorization and billing issues with providers and insurance companies. Improved claims turnaround time by 10% through process optimization and proactive follow-ups.

Education

Degrees, certifications, and relevant coursework

MC

Martinsburg College

Certification, Medical Assistant

Completed a comprehensive program to become a certified Medical Assistant. Gained essential knowledge and skills in medical office administration, clinical procedures, and patient care.

Tech stack

Software and tools used professionally

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JESSICA MCQUIRE - Claims Intake Advocate - Cigna Supplemental | Himalayas