Benita Ledet
Humble,TX
Summary
Detail-oriented and highly analytical professional with experience in claims processing, medical necessity verification, and eligibility assessments. Adept at handling routine claims, identifying discrepancies, and ensuring compliance with established guidelines. Strong problem-solving skills, ability to communicate effectively, and proficiency in utilizing claim processing systems to optimize accuracy and efficiency.
Overview
20
20
years of professional experience
Work History
Owner / Founder
The Ledet Heart Ltd. Co DBA A Unique Heart
Houston, TX
01.2020 - Current
- Process and review claims-related documentation, ensuring adherence to established guidelines
- Conduct eligibility verification and apply necessary cost containment measures in claims adjudication
- Manage and respond to inquiries related to claims processing and discrepancies
- Identify and triage complex claim issues, escalating as necessary for further resolution
- Utilize system functions to verify and process claims with accuracy and compliance
- Train and mentor team members on claims adjudication processes when acting as a subject matter expert
Administrative Assistant 4
Wells Fargo Bank
Houston, TX
01.2007 - 01.2020
- Verified financial transactions, ensuring compliance with company policies and industry regulations
- Conducted eligibility and compliance checks for financial services and transactions
- Managed documentation processes, reviewed financial claims, and facilitated timely resolutions
- Coordinated responses for inquiries regarding financial policies and customer claims
- Provided analytical support to ensure timely and accurate claims processing
Certified Personal Banker
Wells Fargo Bank
Houston, TX
01.2007 - 01.2009
- Evaluated financial claims and provided solutions aligned with customer needs and company policies
- Conducted customer inquiries and processed transactions efficiently
Insurance Adjuster / Assistant
Yvette Cobb Insurance Agency
Fort Worth, TX
01.2005 - 01.2007
- Processed and reviewed insurance claims, ensuring compliance with regulatory guidelines
- Conducted eligibility verification and facilitated policy updates
- Managed claims inquiries and provided support for claim adjudication processes
Education
MBA - SURE Business
C.T. Bauer College of Business
Houston, TXBachelor of Arts - Theology
University of Houston
Houston, TXHigh School -
Furr High School
Houston, TXSkills
- Claims adjudication and review
- Medical Necessity and Coverage Analysis
- Eligibility Verification
- Cost Containment and Compliance
- Correspondence and Customer Support
- Complex Claim Routing and Triage
- Training and Process Improvement
- Claims System Utilization
Certifications And Skills
- Claims Adjudication & Compliance
- Customer Service & Dispute Resolution
- Financial & Insurance Claims Processing
- Training & Subject Matter Expertise
- Data Analysis & System Utilization
Timeline
Owner / Founder
The Ledet Heart Ltd. Co DBA A Unique Heart
01.2020 - Current
Administrative Assistant 4
Wells Fargo Bank
01.2007 - 01.2020
Certified Personal Banker
Wells Fargo Bank
01.2007 - 01.2009
Insurance Adjuster / Assistant
Yvette Cobb Insurance Agency
01.2005 - 01.2007
MBA - SURE Business
C.T. Bauer College of Business
Bachelor of Arts - Theology
University of Houston
High School -
Furr High School
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