Carol A. Goldsmith
Weston,WV
Summary
Detail-oriented professional with over 10 years of experience in insurance claims and patient access. Skilled in problem-solving and initiative-taking, driving compliance and customer service excellence to streamline claims processing and improve patient experiences.
Overview
1
1
Certification
36
36
years of professional experience
Work History
PFS HB Insurance Claim Specialist
West Virginia University Hospital
Morgantown, WV
08.2014 - Current
- Reviewed and processed claims for accuracy and compliance with hospital policies.
- Analyzed insurance claims to verify validity, completeness, accuracy, and eligibility for payment.
- Reviewed denied claims and implemented appropriate actions to resolve denials.
- Communicated with patients regarding claim status and required documentation.
- Collaborated with healthcare providers to gather necessary information for claims.
Patient Access Registrar
Stonewall Jackson Memorial Hospital
Weston, WV
01.1991 - 01.2012
- Functioned as patient access registrar, facilitating all patient services for 21 years.
- Managed billing and insurance claims to ensure timely resolution.
- Handled credit management, processing private pay and charity accounts for financial accessibility.
- Processed customer transactions at cash register to facilitate efficient payment experiences.
- Coordinated pre-certification of surgical and injection services in orthopedic office.
- Collaborated with operating room staff for scheduling and service coordination.
Education
High School Diploma -
Lewis County High School
Weston WV05-1987
Skills
- Claims processing
- Claims resolution
- Claims investigation
- Insurance claims analysis
- Compliance verification
- Patient communication
- Proactive communication
- Customer service
- Problem-solving
- Problem resolution
- Organizing and prioritizing work
Certification
- Clarivate
- CRCR
Timeline
PFS HB Insurance Claim Specialist
West Virginia University Hospital
08.2014 - Current
Patient Access Registrar
Stonewall Jackson Memorial Hospital
01.1991 - 01.2012
High School Diploma -
Lewis County High School