Carlotta Smith-McCrary
Jacksonville,FL
Summary
Experienced professional focused on meeting or exceeding objectives seeking Claims Examiner position. Offers advanced training and knowledge of industry best practices. Recognized for leadership, planning abilities and clear, direct communication style.
Overview
26
26
years of professional experience
Work History
Licensed Cosmetologist
Self-employeed
Jacksonville, FL
07.2009 - Current
- Attend regular trainings and workshops to maintain cosmetology license and stay current on techniques and skills.
- Scheduled customer appointments and rearranged individual time slots to meet demand.
- Helped clients achieve desired looks for daily wear and special events by designing makeup strategies for each scenario.
- Processed payments, entering sales in register for prompt customer service.
- Recorded notes for future reference about customer preferences and services delivered.
Client Relations Representative
Sarnova Digitech
Jacksonville, FL
02.2022 - 07.2022
- Reviewed and researched ambulance run reports to ensure accurate claims submission and billing.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of claims processing based on the benefit guidelines.
- Logged call information and solutions provided into internal database.
Patient Account Representative
Southeast Orthopedic Specialists
Jacksonville, FL
10.2018 - 09.2021
- Responded to patient, family and external payer inquiries.
- Posted payments and processed refunds.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Electronically submitted bills according to compliance guidelines.
- Reconciled statements with patient records.
- Monitored flags and resolved urgent items with accuracy and efficiency.
- Contacted patients after insurance was calculated to obtain payments.
- Worked with customer to create debt repayment plan based on current financial condition.
- Entered client details and notes into system for interdepartmental access and review.
Fulfilment Associate
Amazon
Jacksonville, FL
08.2017 - 10.2018
- Followed procedures at all times for personal and team safety.
- Received and reviewed new orders, located requested merchandise and promptly initiated processing.
- Cross-trained new associates on picking and filling orders for warehouse products.
- Reviewed daily queue report to confirm all orders were processed within shipping system as scheduled.
- Maintained compliance with company safety policies and called violations to attention of management.
Customer Service Representative
Citibank
Jacksonville, FL
01.2016 - 06.2017
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Answered constant flow of customer calls with minimal wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Delivered prompt service to prioritize customer needs.
Customer Service Advocate II
Blue Cross And Blue Shield Of Florida, BCBSF
Jacksonville, FL
12.1999 - 11.2006
- Built long-term, loyal customer relations by providing top-notch service and detailed order, account and service information.
- Assessed caller accounts to determine Health benefits, identify service needs and resolve issues.
- Communicated with providers to resolve denied and resubmitted claims.
- Managed and reviewed large volume of medical claims on a daily basis.
- Adjudicated claims when necessary to ensure proper processing.
Education
Computer Applications
Florida State College At Jacksonville
Jacksonville, FLSkills
- Insurance claims processing
- Health insurance knowledge
- Healthcare Common Procedures Coding System (HCPCS)
- Medical Terminology
- ICD 10 Codes
- Attention to Detail
- Customer Data Confidentiality
- Claims Evaluations
- Customer Relations
- Microsoft Excel
- Data Entry and Maintenance
Timeline
Client Relations Representative
Sarnova Digitech
02.2022 - 07.2022
Patient Account Representative
Southeast Orthopedic Specialists
10.2018 - 09.2021
Fulfilment Associate
Amazon
08.2017 - 10.2018
Customer Service Representative
Citibank
01.2016 - 06.2017
Licensed Cosmetologist
Self-employeed
07.2009 - Current
Customer Service Advocate II
Blue Cross And Blue Shield Of Florida, BCBSF
12.1999 - 11.2006
Computer Applications
Florida State College At Jacksonville
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