Carisma Smith
Columbus,USA
Summary
Adaptable professional with a proven ability to learn quickly and thrive in dynamic environments. Expertise in investigating, negotiating, and settling complex insurance claims. Strong skills in identifying root causes and analyzing policy coverage, leading to enhanced process efficiency and improved customer satisfaction. Maintained secure electronic and hardcopy claims records in compliance with HIPAA regulations.
Overview
10
10
years of professional experience
Work History
Customer Service Representative I II & III
Elevance Health/Anthem
Columbus, USA
10.2020 - Current
- Addressed health insurance benefit inquiries and guided customers through claims processes.
- Analyzed data from rejected claims to drive successful resolutions.
- Provided comprehensive information on health insurance plans and coverage options.
- Enhanced user functionality by integrating third-party applications with MS Office programs.
- Developed robust customer relationships through proactive communication via calls and mail
Customer Support Specialist
At Home Décor Superstore
Columbus, USA
01.2017 - 10.2023
- Provided exceptional customer service through active listening and engagement techniques.
- Trained new team members on cash register operations, stock procedures, and customer service best practices.
- Entered customer, payment, and inventory data into systems to maintain accuracy.
- Executed data entry tasks for collected information into database systems.
- Ensured compliance with retail operation laws and regulations.
- Resolved customer complaints efficiently to enhance satisfaction.
- Cultivated relationships with regular customers, delivering personalized service to promote repeat business.
Medical Receptionist
Columbus Foot Care Associates
Columbus, USA
05.2018 - 10.2020
- Safeguarded medical information while communicating compassionately with patients.
- Entered insurance details, demographics, and health history into patient database.
- Scheduled appointments, followed up on statuses, processed payments, and maintained patient files.
- Transmitted medical records and correspondence through mail, email, or fax.
- Informed patients of financial responsibilities prior to rendering services.
- Verified patient eligibility for medical claims and assessed benefit coverage.
Medical Office Assistant
Community Dialysis Center
Columbus, USA
10.2015 - 12.2016
- Entered billing codes into computer system, ensuring reimbursement accuracy.
- Coordinated with Medicare, Medicaid, and private insurers to resolve billing discrepancies.
- Processed referrals for specialists and diagnostic tests efficiently.
- Performed clerical tasks, including call answering, document filing, and data entry.
- Maintained strict adherence to HIPAA guidelines for patient confidentiality.
Education
Bachelor of Science - Health Administration
University of Phoenix
08.2019
Associate of Science - Dental Hygiene
Miller Motte Technical College
01.2015
High school Diploma or GED -
Shaw High School
Columbus, GA05.2012
Skills
- Data entry and database management
- Customer relations and complaint handling
- Call center operations
- Health information technology
- Claims processing and analysis
- Electronic medical records management
- Insurance verification and policy knowledge
- Effective communication skills
- Attention to detail
- Medical billing and HIPAA compliance
- Data analysis and adjustments processing
- Benefits coordination and claims investigation
- Coverage determination
Timeline
Customer Service Representative I II & III
Elevance Health/Anthem
10.2020 - Current
Medical Receptionist
Columbus Foot Care Associates
05.2018 - 10.2020
Customer Support Specialist
At Home Décor Superstore
01.2017 - 10.2023
Medical Office Assistant
Community Dialysis Center
10.2015 - 12.2016
Bachelor of Science - Health Administration
University of Phoenix
Associate of Science - Dental Hygiene
Miller Motte Technical College
High school Diploma or GED -
Shaw High School