Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ebony Smith

Summary

Ready to help the team achieve company goals. Enthusiastic about handling time-sensitive tasks . Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

13
13
years of professional experience

Work History

Claims Processor

United Healthcare, UHG
06.2023 - Current
  • Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
  • Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
  • Reviewed applications and supporting documents to verify claims eligibility and accuracy.
  • Managed workload and priorities to meet claims processing meet deadlines.
  • Evaluated accuracy and quality of data entered into CPA and Cosmos.
  • Improved speed and accuracy of data entry, utilizing advanced software and technology to support claims processing.
  • Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
  • Enhanced claim processing efficiency by implementing new software and streamlining procedures PSI, Sophia.

Patient Support Specialist

Liveops
08.2017 - 06.2023
  • Followed document protocols to safeguard confidentiality of patient records.
  • Taught patients and families to use at-home medical collection kit.
  • Worked flexible hours; night, weekend, and holiday shifts.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Determined prior authorizations for medication and outpatient procedures.
  • Make adjustments to patients' demographic, insurance, and account balance information.
  • Researched CPT and ICD-9 coding discrepancies before transferring them to the Billing department.
  • Continued education on new policies and procedures

Medical Technician

Guardian Alarm Security
10.2017 - 06.2020
  • Monitored inventory levels of supplies, equipment and reagents used and placed orders for replacements.
  • Interviewed patients to obtain medical history
  • Interacted with patients and families while demonstrating high standards of performance, teamwork and compassion.
  • Inspected, tested and calibrated medical equipment before installing.
  • Diagnosed cause of problems and completed repairs.
  • Documented information regarding installations, repairs and inventory checks.
  • Maintained safe work environment and adhered to privacy regulations.
  • Carried out day-day-day duties accurately and efficiently.
  • Worked flexible hours; night, weekend, and holiday shifts.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.

Medical Collections Representative

National Patient Account Services
10.2015 - 08.2017
  • Negotiated to collect balance in full.
  • Processed payments and contracts on accounts.
  • Counseled debtors on payment options and arranged installment agreements.
  • Resolved challenging situations with friendly but firm strategies.
  • Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
  • Maintained high volume of calls and met demands of busy and productive group.
  • Processed payments and applied to customer balances.

Sales Associate

Uhaul Moving And Storage
03.2013 - 10.2015
  • Answered customer questions regarding sizing, accessories and proper care for merchandise.
  • Engaged with customers to effectively build rapport and lasting relationships.
  • Achieved perfect attendance and on-time record.
  • Implemented up-selling strategies such as recommending accessories and complementary purchases to boost revenue.
  • Tracked stock using company inventory management software.
  • Consistently maintain call average time
  • Met collection quota monthly

Customer Service Specialist

Teleflora
02.2012 - 02.2015
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
  • Took payment information and other pertinent information such as addresses and phone numbers to place orders.
  • Complied with company policies and procedures by encouraging positive and effective work environment among all employees.
  • Resolved concerns with products or services to help with retention and drive sales.
  • Described product highlights and benefits to help guide purchasing decisions.
  • Handled over 150 calls per shift signing up new customers, retrieving customer data, presenting relevant product information and cancelling services.

Education

High School Diploma -

Washington Park Highschool
06.2003

Skills

  • Company Guidelines
  • World-Class Customer Experience
  • HIPPA training
  • Regulations
  • Medical Terminology

Excellent Attention to Detail

Accuracy and Precision

Microsoft Office

Claims Processing Software

Data entry proficiency

Prior authorization processing

Timeline

Claims Processor

United Healthcare, UHG
06.2023 - Current

Medical Technician

Guardian Alarm Security
10.2017 - 06.2020

Patient Support Specialist

Liveops
08.2017 - 06.2023

Medical Collections Representative

National Patient Account Services
10.2015 - 08.2017

Sales Associate

Uhaul Moving And Storage
03.2013 - 10.2015

Customer Service Specialist

Teleflora
02.2012 - 02.2015

High School Diploma -

Washington Park Highschool

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Ebony Smith