Open To Work
Catrina Smith
Nacogdoches,TX
Summary
Experienced claims processor adept at investigating claim information for accuracy. Trusted teammate with extensive benefit knowledge and exceptional rapport-building abilities. Recognized for meticulousness and commitment to ethical customer service.
Overview
9
9
years of professional experience
Work History
Operation Account Manager/Claims Processor
UnitedHealthcare
Minnetonka, MN
07.2022 - Current
- Ensured consistent quality service to exceed performance benchmarks.
- Resolved product and consumer complaints efficiently through strong communication skills
- Handled client concerns promptly, resulting in enhanced satisfaction
- Liaised with healthcare providers for missing information on claims
- Investigated medical claims to ensure validity
- Ensured timely submission of required audit documentation
- Worked with adjusters and underwriters to settle intricate claims
- Determined customer needs and requirements through daily email communication
- Maintained updated records to guarantee proper benefit allocation according to plan
Remote Customer Service Representative
Empire Reality Group
Fort Worth, TX
09.2020 - 08.2021
- Achieved a 45% customer retention rate in prior positions
- Utilized investigative questioning to identify customer service requirements
- Ensured customer contentment via effective problem-solving
- Stayed informed on current promotional offers, return guidelines, billing practices
- Executed outbound calls to gather information and provide payment assistance
Patient Account Representative II
Nacogdoches Memorial Hospital
Nacogdoches, TX
01.2019 - 11.2019
- Drafted appeals to challenge insurance claim denials
- Integrated online insurance data into electronic health records
- Oversaw collections processes alongside insurance claim management
- Evaluated benefits and remittance documents for discrepancies
- Processed claims for top commercial payers including Blue Cross, Aetna, United Healthcare.
- Submitted electronic invoices in compliance with legal standards
Production Assembler
Ingersoll Rand
Tyler, TX
01.2016 - 03.2019
- Studied assembly instructions, blueprint specifications and parts lists to prepare work
- Conducted assembly by examining and fastening components
- Completed production and quality documentation accurately.
- Operated swiftly to ensure timely completion of tasks
- Assisted in production of wiring parts and tools
Internship Student
Clinic Business Office
Tyler, TX
07.2018 - 12.2018
- Uploaded electronic insurance information to EHR
- Administered collections and insurance claims with precision
- Answered and directed multiple phone lines effectively
- Observed colleagues to gain specialized knowledge
- Utilized strong verbal abilities to engage customers in meaningful conversations
Education
Associate of Applied Science - Medical Insurance Coding
Tyler Junior College
Tyler, TX12.2019
Associate of Science - Medical Office Management
Tyler Junior College
Tyler, TX12.2019
Associate of Applied Science - Liberal Arts And General Studies
Panola College
Carthage, TX05.2016
Skills
- Client Relationship Management
- Customer Service
- Account Management
- Goals and performance
- Networking skills
- Relationship building and management
- Operations
- Collections expertise
References
References available upon request.
Work Preference
Job Search Status
Open to workWork Type
Part TimeLocation Preference
RemoteOn-SiteSalary Range
$45000/yr - $200000/yrTimeline
Operation Account Manager/Claims Processor
UnitedHealthcare
07.2022 - Current
Remote Customer Service Representative
Empire Reality Group
09.2020 - 08.2021
Patient Account Representative II
Nacogdoches Memorial Hospital
01.2019 - 11.2019
Internship Student
Clinic Business Office
07.2018 - 12.2018
Production Assembler
Ingersoll Rand
01.2016 - 03.2019
Associate of Applied Science - Medical Insurance Coding
Tyler Junior College
Associate of Science - Medical Office Management
Tyler Junior College
Associate of Applied Science - Liberal Arts And General Studies
Panola College