Jacki Wherley

Dedicated healthcare claims and customer service professional with extensive experience in medical, dental, and workers' compensation claims, member advocacy, project coordination, auditing, and operational support. Recognized for exceptional problem-solving abilities, cross-functional training expertise, and delivering high-quality service in fast-paced environments.

Carrier / Client Service Representative - International Benefit Administrators

(2022-09 - 2026-05)

• Assisted members by addressing questions, resolving concerns, and providing information through electronic communication channels.
• Processed member and provider appeals while reviewing medical records for medical necessity and pre-existing conditions.
• Participated in projects to identify trends and improve operational processes and outcomes.
• Assisted management with auditing employee work performance for accuracy, quality, and compliance.
• Communicated effectively with clients and vendors to resolve inquiries and provide updates.
• Assisted management with entering plan documentation and processing overpayments and refunds.

Member Advocate / Customer Service Representative / Medical Claims Adjuster - Allied Benefit Systems

• Processed medical, dental, and workers' compensation claims accurately and efficiently.
• Handled high-volume inbound calls in a fast-paced call center environment.
• Responded to escalated member concerns and management callback requests on the Care Team.
• Provided exceptional member support while resolving complex claims and benefit inquiries.
• Assisted with training and cross-training staff across multiple departmental functions.

Project Supervisor / Medical, Dental & Workers' Compensation Adjuster - HCH Administration

(1995-02 - 2012-10)

• Analyzed and monitored trends to improve operational performance and support training of claims adjusters.
• Evaluated and processed claims to ensure compliance with benefit plans, policies, and regulations.
• Handled inbound customer service calls while maintaining high-quality member support.

General Studies - Illinois Central College (2000 - 2003)

Southeastern Academy of Travel & Tourism (1987)

Oak Creek High School (1982 - 1986)