JESSICA MCQUIRE
@jessicamcquire
Experienced Claims Specialist with a decade in healthcare claims processing.
What I'm looking for
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
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.
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.
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
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.
Availability
Location
Authorized to work in
Job categories
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