JEANETTE OGILVIE
JONESBORO
Summary
Accomplished service professional with a proven history of managing projects and operations for on-time delivery. Esteemed for leadership and analytical expertise, experienced in cross-functional collaboration. Excels in customer service by leveraging strong listening and problem-solving abilities.
Overview
28
28
years of professional experience
Work History
Account Resolution Specialist
WellStar
06.2025 - Current
- Resolved account discrepancies through detailed analysis and effective communication with clients.
- Implemented new procedures for tracking outstanding accounts, improving resolution timelines.
- Trained junior staff on best practices in account management and resolution techniques.
- Prevented revenue loss by promptly identifying and addressing potential payment delinquencies.
- Created detailed documentation for each case handled, ensuring proper record-keeping for future reference or audits purposes.
- Completed in-depth research to investigate claims and resolve problems.
INBOUND CUSTOMER SERVICE REP.
CAPITAL RX PBM
10.2022 - 04.2025
- Managed pharmacy benefits for Medicare, Medicaid, and commercial accounts.
- Specialized in reviewing medical documentation for authorization requests.
- Enhanced comprehensive benefits coverage.
- Processed lost, stolen and vacation overrides efficiently.
INBOUND CONTACT REP 2
HUMANA INSURANCE COMPANY
09.2021 - 10.2022
- Provided targeted guidance on various individual Medicare insurance solutions.
- Managed high volume of incoming calls from remote location.
- Facilitated side-by-side rep training through direct shadowing.
- Managed pharmacy overrides and prior authorization requests.
- Managed end-to-end handling of Medicare Part A & B claims.
- Managed Benefits-SMAPD, Duals, SNP, PPO, HIDE/FIDE & PDP Policies.
- Oversaw policy administration including enrollment, reinstatement, and disenrollment.
RESOURCE DEVELOPMENT SPECIALIST
DEPT. OF FAMILY & CHILDREN SERVICES
04.2014 - 12.2018
- Conducted thorough inspections of foster care homes.
- Conducted instructional workshops for prospective foster caregivers.
- Conducted yearly assessment of Foster homes.
- Performed quarterly reviews on conditions in foster homes.
- Managed invoicing and payments related to foster care programs.
CUSTOMER SRV AGENT
PHILLIPS HEALTHCARE
03.2013 - 01.2014
- Delivered exceptional customer service in high-volume call center environments.
- Ensured efficient handling of a minimum of 70 calls each shift.
- Reviewed medical equipment claims efficiently.
- Coordinated dispatch of technicians to multiple locations.
CUSTOMER SRV AGENT
DELTA AIRLINES
01.2006 - 12.2012
- Coordinated timely aircraft loading.
- Coordinated bag assistance services for regional passengers.
- Managed efficient transfer of cargo during aircraft loading and unloading.
- Guided incoming aircraft to their designated gates.
RESERVATIONS SPECIALIST
AIRTRAN AIRWAYS
11.2004 - 12.2006
- Handled incoming calls on a complex multi-line system.
- Coordinated and modified client reservations.
- Established customer credit lines and set up credit accounts
COORDINATION OF BENEFITS REP.
GHI INC
01.2001 - 08.2004
- Responsible for coordinating medical benefits for Medicare eligible beneficiaries.
- Handled at minimum 70 incoming phone inquiries per shift.
- Updated records to reflect primary payer information to ensure proper payment of claims.
- Resolved claims payment issues for providers, attorneys and other insurance carriers.
- Ensured 100% regulatory compliance with the Centers for Medicare and Medicaid Services (CMS) including The Health Insurance and Portability and Accountability Act (HIPAA).
- Created and maintained records to reflect auto no fault, liability and workers compensation cases for attorneys and beneficiaries.
- Assisted employers with government implemented data match questionnaires.
CARE SPECIALIST
SUNY DOWNSTATE MED CTR
03.2000 - 01.2001
- Maintained Medical records
- Processed Medical claims
- Handled all billing & collections
- Processed third party liability claims
PUBLIC HEALTH SANITARIAN
NYC DEPT. OF HELTH
01.1998 - 02.2000
- Conducted restaurant and school kitchen inspections.
- Issued written violations
- Conducted building window guard inspections.
- Attended administrative tribunals.
Education
B.S. - BIOLOGY
LINCOLN UNIVERSITY
OXFORD, PA12.1995
Skills
- Microsoft Office Suite
- Salesforce CRM
- Prompt PA software
- RX Nova system
- RX Connect Pro platform
- Client management systems
- Mac and PC proficiency
- Solutran integration
Timeline
Account Resolution Specialist
WellStar
06.2025 - Current
INBOUND CUSTOMER SERVICE REP.
CAPITAL RX PBM
10.2022 - 04.2025
INBOUND CONTACT REP 2
HUMANA INSURANCE COMPANY
09.2021 - 10.2022
RESOURCE DEVELOPMENT SPECIALIST
DEPT. OF FAMILY & CHILDREN SERVICES
04.2014 - 12.2018
CUSTOMER SRV AGENT
PHILLIPS HEALTHCARE
03.2013 - 01.2014
CUSTOMER SRV AGENT
DELTA AIRLINES
01.2006 - 12.2012
RESERVATIONS SPECIALIST
AIRTRAN AIRWAYS
11.2004 - 12.2006
COORDINATION OF BENEFITS REP.
GHI INC
01.2001 - 08.2004
CARE SPECIALIST
SUNY DOWNSTATE MED CTR
03.2000 - 01.2001
PUBLIC HEALTH SANITARIAN
NYC DEPT. OF HELTH
01.1998 - 02.2000
B.S. - BIOLOGY
LINCOLN UNIVERSITY
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