Ashlie Houston
Columbus,GA
Summary
Dynamic Claims Representative with proven expertise at AmeriBen in processing and adjudicating claims while enhancing client communication. Skilled in claims investigation and critical thinking, I effectively identified process improvements, ensuring compliance and efficiency. Committed to delivering exceptional service and fostering teamwork in fast-paced environments.
Overview
6
6
years of professional experience
Work History
Claims Representative I
AmeriBen
Columbus, GA
02.2025 - Current
- Processed and adjudicated claims accurately according to company policies and guidelines.
- Analyzed claim documentation to ensure completeness and compliance with regulatory standards.
- Facilitated communication between clients, providers, and internal teams to resolve claims inquiries promptly.
- Identify process gaps and recommend improvements related to NSA claim handling workflows.
- Prepare and send provider recoupment letters for overpaid claims.
- Manage inbound correspondence by monitoring and responding to emails in a timely, professional manner.
- Coordinate with external vendors to validate claim eligibility and requirements under NSA.
- Enter and maintain updated pricing and reimbursement data accurately within applicable systems.
Call Center Customer Service Representative
Aflac
Columbus, GA
09.2023 - 02.2025
- Resolved customer inquiries through effective communication and problem-solving skills.
- Provided accurate information on insurance policies and coverage options to enhance customer understanding.
- Assisted customers in navigating claims processes, ensuring clarity and efficiency in each interaction.
- Maintained high levels of customer satisfaction by addressing concerns promptly and professionally.
- Managed a high volume of calls daily, maintaining composure under pressure while providing exceptional service.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Demonstrated excellent multitasking abilities by simultaneously handling multiple tasks such as navigating systems, taking notes on calls, and answering inquiries from clients.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
Customer Service Representative
Publix
Columbus, GA
01.2023 - 09.2023
- Assisted customers with inquiries, providing accurate product information and resolving issues promptly.
- Processed transactions efficiently, maintaining cash accuracy and ensuring customer satisfaction during checkout.
- Trained new staff on customer service protocols and best practices to ensure consistent service delivery.
- Handled customer complaints professionally, employing conflict resolution techniques to maintain brand loyalty.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Responded to customer requests for products, services, and company information.
Cashier
Publix
Columbus, GA
05.2021 - 01.2023
- Processed customer transactions efficiently using POS systems.
- Assisted customers with product inquiries and maintained store appearance.
- Balanced cash drawer accurately at beginning and end of shifts.
- Trained new cashiers on procedures and customer service best practices.
- Monitored inventory levels at checkout area, restocking as necessary to meet demand.
- Greeted customers entering store and responded promptly to customer needs.
- Maintained up-to-date knowledge of store policies and procedures, ensuring compliance in all transactions.
- Enhanced shopping experience, provided product information and location assistance.
Grocery Bagger
Publix
Columbus, GA
07.2020 - 05.2021
- Pack grocery items efficiently to ensure customer satisfaction and minimize wait times.
- Maintain cleanliness and organization of bagging area, adhering to safety standards.
- Collaborate with team members to streamline bagging processes during peak hours.
- Assist customers in carrying bags to their vehicles, enhancing overall shopping experience.
- Performed regular inspections and cleaning of restroom facilities, enhancing overall cleanliness and user satisfaction.
- Follow store protocols for handling perishable items to maintain product quality.
- Adapt quickly to changing demands during busy periods, ensuring timely service delivery.
- Support training of new employees in proper bagging techniques and customer interaction.
Education
High School Diploma -
Hardaway High School
Columbus, GASkills
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Team collaboration
- Claims processing
- Critical thinking
- Teamwork and collaboration
- Medical terminology
- Adaptability and flexibility
- Settlement determinations
- Documentation research
Timeline
Claims Representative I
AmeriBen
02.2025 - Current
Call Center Customer Service Representative
Aflac
09.2023 - 02.2025
Customer Service Representative
Publix
01.2023 - 09.2023
Cashier
Publix
05.2021 - 01.2023
Grocery Bagger
Publix
07.2020 - 05.2021
High School Diploma -
Hardaway High School