Carmelitta Burt
Kansas City,MO
Summary
Versatile and analytical professional with a background in education, insurance, and client support, complemented by an MBA and strong communication skills. Experienced in process analysis, problem resolution, and cross-functional collaboration. Adept at learning new systems, supporting users, and translating complex information into practical solutions. Seeking to contribute to a dynamic organization through a role that values adaptability, service excellence, and continuous improvement.
Overview
24
24
years of professional experience
4
4
years of post-secondary education
Work History
Claims Generalist Associate
Progressive Insurance
06.2023 - Current
- Enhanced claim processing efficiency by thoroughly reviewing and analyzing documents submitted for each case.
- Provide top-notch customer service throughout the claims process, ensuring a positive experience for policyholders and reinforcing brand reputation.
- Expedite claim resolutions through effective communication with clients, providers, and other stakeholders.
- Manage high-volume caseloads while consistently meeting deadlines and maintaining quality standards for claim submissions.
- Improved customer satisfaction ratings by providing prompt and accurate responses to inquiries regarding claim status.
Revenue Cycle Specialist
Axiva Health Solutions
07.2022 - Current
- Utilize available resources to research and resolve claim denials, while also ensuring posting accuracy by carefully reviewing electronic remittance advices (ERA).
- Bill and collect on major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy.
- Complete and submit necessary claim forms and electronic claims to process them in accordance with timely filing requirements set by all third-party payors.
- Consistently deliver high-quality work as remote team member, meeting or exceeding production goals.
Middle School Teacher
Grandview C4 School District
08.2011 - 06.2023
- Increased student engagement and achievement by developing and delivering Career Exploration curriculum.
- Developed and maintain positive relationships with students, parents, leadership, and colleagues to provide exceptional service and support.
- Collaborate with team members to analyze student performance data and implement evidence-based instructional strategies.
- Led professional development sessions for colleagues on effective instructional practices.
- Document and maintain confidential records of student grades and behavior, ensuring accuracy and compliance with data privacy regulations.
- Collaborate with administration and team members to conduct interviews and identify top candidates for various positions.
Risk Assessment Interviewer
Quest Diagnostics
11.2020 - 12.2021
- Gathered medical, financial, occupational and avocation histories for life insurance applicants.
- Consistently delivered high-quality work as a remote team member, meeting or exceeding production goals.
- Recognized for consistently achieving high levels of accuracy and customer service excellence in quality reviews.
Claims Adjudicator
Gentiva Health Services
03.2004 - 01.2006
- Evaluated and processed medical claims in accordance with company policies and procedures.
- Used oral and written communication skills to report claim status to service providers.
- Analyzed data for in-process claims to identify and resolve errors.
Customer Service Associate
Farmer's Insurance
09.2001 - 09.2002
- Initiated and guided policyholders through the claims reporting process in call-center environment.
- Gathered accurate and detailed liability statements from policyholders to support efficient claims processing.-
- Investigated accidents or incidents to determine cause and extent of damages.
- Worked productively in fast-moving work environment to process large volumes of claims.
Education
Master of Business Administration -
Northwest Missouri State University
Maryville, MO 06.2018 - 2020.05
Bachelor of Science -
University of Central Missouri
Warrensburg, MO 08.2006 - 12.2010
Skills
- Time management
Problem-solving
Relationship cultivation and retention
Decision-making
Written and Oral Communication
Microsoft 365
Multi-tasking
Customer Service
Timeline
Claims Generalist Associate
Progressive Insurance
06.2023 - Current
Revenue Cycle Specialist
Axiva Health Solutions
07.2022 - Current
Risk Assessment Interviewer
Quest Diagnostics
11.2020 - 12.2021
Master of Business Administration -
Northwest Missouri State University
06.2018 - 2020.05
Middle School Teacher
Grandview C4 School District
08.2011 - 06.2023
Bachelor of Science -
University of Central Missouri
08.2006 - 12.2010
Claims Adjudicator
Gentiva Health Services
03.2004 - 01.2006
Customer Service Associate
Farmer's Insurance
09.2001 - 09.2002
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