Jacquila (Jackie) Martin

• Verify ICD 10, CPT and HCPCS codes to determine need for pre-authorization according to insurance guidelines.
• Assist providers on the prior approval process, status, initiate appeals and peer to peer reviews
• Verify Claim Status
• Investigate reasons behind claim denials.
• Collaborate with various internal and external departments and to resolve complex claim issues
• Initiate adjustments for claims that processed in error
• Assist members, internal staff, healthcare providers, group representatives and other insurance companies via with benefits, eligibility and coordination of benefits, network participation, ect
• Handle case management using Salesforce.
• Performed system-based research to address concerns.

• Assisted patients with daily living activities
• Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
• Completed required electronic charting

Traveled to surrounding area facilities and homes to provide nursing care

• Checked patient vitals such as temperature, blood pressure, and blood sugar levels
• Assisted patients with daily living activities
• Reduced fall incidents by implementing safety measures like bed alarms and proper positioning techniques