Erica Smith
Brooklyn Park,MN
Summary
Professional and efficient Sr. Claim Benefit Specialist dedicated to minimizing customer dissatisfaction and fostering customer loyalty. Committed to addressing customer concerns with speed and accuracy, consistently maintaining a high level of professionalism, patience, and efficiency.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Sr. Claim Benefit Specialist, Account Analyst
Aetna, a CVS Health
10.2016 - Current
- Championed efforts towards maintaining a positive work environment within the Claims Department by promoting teamwork and collaboration.
- Implemented cost-saving measures through strategic negotiations with medical facilities and service providers involved in claims disputes.
- Participated in industry conferences and workshops to stay informed about emerging trends affecting benefits administration practices.
- Contributed to revenue growth by identifying opportunities for targeted marketing campaigns based on customer segments.
- Collaborated with cross-functional teams to develop new product offerings tailored to client needs.
- Mentored junior staff members, developing their skills in claim analysis, negotiation, and settlements.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance throughout the claims process.
- Reduced claim resolution time with thorough investigations and efficient communication with policyholders and providers.
- Managed a team of junior claim benefit specialists for increased productivity and quality outcomes.
- Processed and recorded new policies and claims.
Retirement Services Account Management
Wells Fargo
01.2016 - 10.2016
- Made reasonable procedure exceptions to accommodate unusual customer requests
- Provided accurate and appropriate information in response to customer inquiries
- Demonstrated mastery of customer service call script within specified timeframes
- Addressed customer service inquiries in a timely and accurate fashion
- Maintained up-to-date records at all times
- Formulated and enforced Service Center policies, procedures and quality assurance measures
- Properly directed inbound calls in phone queues to improve call flow.
- Managed customer 401k accounts
Medical Assemble
Medtronic
04.2010 - 08.2014
- Set up and performed hand and automatic assembly operations on components, sub-assemblies and assemblies
- Assembled components with hand and power tools
- Assessed work for errors or compliance issues and made corrections and modifications when necessary
- Lubricated and wiped machines, tools and workplace to maintain safety and cleanliness
- Improved knowledge and productivity through continuous education and learning from foreman and senior assemblers
- Completed and entered quality records, scrap reports and machine logs in a timely manner
- Reviewed and verified all work was in compliance with sales orders and customer requirements.
Education
High School Diploma - General
Thronwood Highschool
Eden Prairie, IL01.2009
Skills
- High customer service standards
- Dedicated to process improvement
- Conflict resolution proficiency
- Customer service management expertise
- Strong problem solving ability
- Negotiation competency
- Training manual contributor
- Proficient with Microsoft Office Suite
Certification
- Corporate Records Management
- Contracts and Non-Merchandise Purchase Policies
- Business Conduct and Integrity
- Risk Management
- Global Security
- Firewall Training
- Business Analysis and Underwriting
- Medical and Dental Terminology
- Office 365
- PHI and Privacy Breaches
- Windows 10
Timeline
Sr. Claim Benefit Specialist, Account Analyst
Aetna, a CVS Health
10.2016 - Current
Retirement Services Account Management
Wells Fargo
01.2016 - 10.2016
Medical Assemble
Medtronic
04.2010 - 08.2014
High School Diploma - General
Thronwood Highschool
- Corporate Records Management
- Contracts and Non-Merchandise Purchase Policies
- Business Conduct and Integrity
- Risk Management
- Global Security
- Firewall Training
- Business Analysis and Underwriting
- Medical and Dental Terminology
- Office 365
- PHI and Privacy Breaches
- Windows 10
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