Andre Jackson Email & Phone Number

Nashville, Tn, Us

Nashville, Tennessee, United States

-Provided product support for up to 1,000 internal and external customers for web-based application, Health Plan Manager(SaaS). -Utilized ServiceNow(ITSM) to track and correspond to customer inquiries, issues, and enhancements.-Provided tier 1 support for ISG reporting applications to include Titan and BASS.-Performed User Acceptance Testing(UAT) for new features and defects for Health Plan Manager as part of an Agile(Scrum) process. -Scheduled and led Joint Application Development (JAD) meetings with customers and developers to ensure proper defect remediation.-Collaborated with product owners and developers to ensure UAT was completed within sprint and successfully deployed to the production environment. -Led UAT efforts for AVRC Product Support to include testing assignments, timely completion, and UAT tracker management.-Created a new UAT process used by AVRC Product Support which reduced testing time for product owners/managers by 50%. -Utilized Rally (Project Management Software) to create user stories and submit defects.

-Examined and documented business operations to ensure data security and compliance with State and Federal regulations. -Investigated, recovered, and resolved: Medicare and Medicaid claims to produce cost savings on a quarterly basis.-Ensured timely adherence to reimbursement policies and contract compliance; responding to client denials and provider appeals to ensure client satisfaction, which resulted in client loyalty. -Collaborated with the Data Analytics Team to update and refine claim cases to increase profitability. -Exceeded 2020 client and internal recovery goals, resulting in $3.6 Million in client savings.

Greater Nashville Area, Tn

-Implemented technology solutions for Health Plans in a cost-effective manner by determining project requirements and communicating them to stakeholders.-Utilized JIRA and JIRA Service Desk to create user stories and provide end user support.-Led client meetings to identify development requirements, design workflows, and provide product updates.-Performed initial User Acceptance Testing(UAT) to confirm product development met the client expectations.-Successfully moved clients to updated versions of Pareo(SaaS) resulting in contract renewal and new business.

Greater Nashville Area, Tn

-Successfully managed 25+ new claims a month while managing existing inventory including litigated claims. These claims ranged from $1K to $2M+ in cost.-Efficiently made compensability decisions on an average of 12 days or less to drive the department average of 17 days down.-Crafted resolution plans and reserved financials during the claim investigation process to keep internal and external stakeholders appraised of progress and resolution status.-Selected into and completed the Claim Leadership Development Program where I learned and presented on the three leadership competencies (Leading Self, Leading Others, Leading Business). -Conducted TravComp tours where I informed our clients and agents on the benefits of our specialized workers compensation process.

-Completed two financial analysis projects which identified unnecessary spending.-Handled questionable workers' compensation claims under the Investigative Claims Unit to limit fraudulent claims.-Successfully facilitated a school supply fundraiser for Youth Villages.-Analyzed a spreadsheet involving Translation services and determined causation behind trends. -Obtained Texas Insurance Adjuster License by passing a five day adjuster licensing course.

-Analyzed and interpreted Excel worksheets to expose problems and ensure productivity.-Contacted claimants to confirm and request information.-Shadowed Claim Professionals to grasp and overall understanding of the claims process.-Assisted claim handlers by updating claims.-Presented project to upper level management regarding technological opportunities.