Ariel Smith
Bellevue
Summary
Detail-oriented insurance claims specialist with expertise in claims processing and customer service. Demonstrated ability to communicate effectively and solve problems, ensuring timely resolution of client inquiries and complaints.
Overview
17
17
years of professional experience
Work History
Insurance Claims Specialist
State Farm
Richardson
07.2021 - Current
- Processed insurance claims efficiently and accurately for diverse client needs.
- Evaluated policy coverage to determine claim eligibility and required documentation.
- Collaborated with adjusters to gather necessary information for claim resolution.
- Communicated with clients to explain claim processes and address inquiries promptly.
- Analyzed claims data using company-specific software tools to ensure accurate processing.
- Trained new employees on claims procedures and best practices within the team.
- Calculated benefit payments in accordance with policy terms and applicable regulations to support timely claim resolutions.
- Maintained detailed records of all claim activities including correspondence, decisions, payments.
- Reviewed denied claims for errors or omissions before finalizing decision notices.
- Provided guidance to customers regarding their rights and obligations under the insurance policies.
- Analyzed claim records, policy provisions, and other relevant documents to determine validity of claims.
- Resolved customer complaints related to insurance claim processing.
- Determined liability, compensability, and benefits due on each claim.
- Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
- Investigated suspicious or fraudulent claims, documenting findings and informing management for further action.
- Coordinated with external parties such as lawyers, surveyors, appraisers during investigations.
Opossum Construction
Owner-Operator
Bellevue
01.2013 - Current
- Operated hand tools and power tools to support welding operations effectively.
- Followed safety protocols to protect self and others in the workplace.
- Managed daily operations to ensure efficient workflow in business activities.
- Coordinated financial transactions and maintained accurate records to support fiscal accountability.
- Ensured compliance with all local laws, regulations, policies, and procedures related to the operation of the business.
- Monitored financial performance of the business on a weekly basis to ensure fiscal responsibility.
- Developed business plan and budget to maximize profitability.
- Oversaw hiring process for new employees, facilitating recruitment and onboarding training.
- Reconciled daily sales, prepared bank deposits and assessed financial transaction reports.
- Delegated work to staff, setting priorities and goals.
Receptionist
Bowie Pet Clinic
Bowie
05.2015 - 07.2015
- Greeted clients and pets, creating a welcoming clinic atmosphere.
- Managed appointment scheduling using clinic software for efficient operations.
- Answered phone calls, providing information and assisting with inquiries.
- Processed patient records with accuracy, maintaining organized and accessible documentation.
- Assisted veterinarians with patient check-ins and preparation for examinations.
- Handled billing and payment processing, fostering clear communication and trust with clients.
- Coordinated with team members to enhance collaboration and ensure seamless daily clinic operations.
- Provided excellent customer service at all times while interacting with both internal and external customers.
- Performed data entry tasks into various computer systems accurately and promptly.
Waitress
Armadillo Grill
Bowie
06.2011 - 05.2012
- Provided excellent customer service in a fast-paced dining environment.
- Took and processed customer orders accurately and efficiently.
- Collaborated with kitchen staff to coordinate timely food delivery for enhanced dining experience.
- Assisted customers with menu selections and answered questions.
- Monitored inventory levels and communicated needs to management.
- Developed positive relationships with regular customers through friendly conversation.
- Greeted customers, answered questions, and recommended specials to increase profits.
- Assisted other wait staff members in times of heavy customer traffic.
- Checked back with customers during meal service to confirm satisfaction and address needs promptly.
- Maintained accuracy while handling payments, giving change and printing receipts for customers.
- Cleared and reset tables quickly during busy dining periods to maintain flow.
- Utilized POS system to accurately calculate meal costs and apply taxes for seamless billing.
Department Manager
Walmart
Deccatur
08.2009 - 05.2011
- Supervised team members and trained on retail best practices to enhance customer service.
- Coordinated inventory management and restocking procedures for optimal product availability.
- Managed shift overstock and controlled inventory to maintain optimal stock levels.
- Implemented visual merchandising standards to improve product presentation.
- Conducted regular evaluations of team performance and provided constructive feedback.
- Adhered to safety protocols during daily operations.
Education
Associate of Arts - Business Management
North Central Texas College
Gainesville, TX05-2013
Medical Coding Certificate - Medical Coding
American Commercial College
Wichita Falls, TX05-2008
Some College (No Degree) - Business Management
Capella University
05-2026
Skills
- Claims processing
- Claims investigation
- Claims analysis
- Policy interpretation
- Policy implementation
- Insurance terminology
- Customer service
- Financial transactions
- Documentation processing
- Data entry software
- Form preparation
- Client interviews
- Amount calculation
- Time management
- Case management
- Team collaboration
- Team building
- Teamwork
- Multitasking capacity
- Problem-solving
- Analytical skills
- Attention to detail
- Effective communication
- Written communication
- Professionalism
- Dispute resolution
- Computer proficiency
- Microsoft office
- Critical thinking
- Adaptability
- Continuous improvement
- Worksite safety
- Reliability
- Professionalism
- Professional demeanor
- Task prioritization
- Interpersonal skills
- Hazard identification
- Construction safety
- Payroll administration
- Inventory management
- Basic welding
- Laboring Experience
- OSHA regulations
- Teamwork
- Effective communication
Timeline
Insurance Claims Specialist
State Farm
07.2021 - Current
Receptionist
Bowie Pet Clinic
05.2015 - 07.2015
Opossum Construction
Owner-Operator
01.2013 - Current
Waitress
Armadillo Grill
06.2011 - 05.2012
Department Manager
Walmart
08.2009 - 05.2011
Associate of Arts - Business Management
North Central Texas College
Medical Coding Certificate - Medical Coding
American Commercial College
Some College (No Degree) - Business Management
Capella University