Summary
Overview
Work History
Education
Skills
Additional Information - Skill Highlights
References
Timeline
Generic

ISIS SMITH

Stone Mountain,GA

Summary

Experienced insurance professional with 3-year career assessing properties, determining liabilities and negotiating settlements. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care. Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations.

Overview

9
9
years of professional experience

Work History

Claims Analyst

Towne Park, Ltd
Remote, PA
01.2021 - Current
  • Investigate, create, and maintain all reimbursement related information and data to ensure regulatory compliance
  • Manage reserve adjustments and payments
  • Monitoring the totality of the claim
  • Collect and analyze information provided
  • Prepare written summary/recommendations to resolve claims
  • Investigated claim and settlement deals and reviewed coverage determinations.
  • Answer client/patient questions to ensure understanding for client/patient satisfaction.
  • Reviewed customer claims, identified discrepancies and determined appropriate course of action.
  • Conducted research on industry trends and best practices related to paradigm shifts in order to inform decisions.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Identified needs of customers promptly and efficiently.
  • 25-75 Inbound and Outbound calls in total daily
  • Followed all company procedures to keep data confidential.

Retail Associate Manager

T-Mobile
Dallas, GA
09.2016 - 08.2021
  • Daily inventory counts
  • Assisted customers in resolving complaints or issues regarding products or services.
  • Trained, supervised, and evaluated retail staff performance.
  • Cash handling/deposits
  • Developed and implemented customer service standards to ensure a positive shopping experience.
  • Device troubleshooting
  • Billing and account audits
  • Floor Coaching Mobile Experts
  • Sales training and development to employees
  • Chat support via app services.
  • Assisted customers in setting up new devices and transferring data from old to new devices.
  • Demonstrated the use of various applications on mobile devices such as email, messaging, music, photos.
  • Provided customer service and technical support for mobile devices, tablets, and other wireless products.
  • Provided guidance on how best to secure personal information stored on a user's device through security measures such as password protection.
  • Maintained knowledge of sales and promotions, return policies and security practices.
  • Maintained records related to sales for store management.
  • Organized store by returning merchandise to proper areas and restocked displays.

Sales Associate

Journey's
Lithonia, GA
01.2015 - 11.2017
  • Visual Merchandising
  • Greeted customers and provided exceptional customer service.
  • Inventory management
  • Built relationships with customers to encourage repeat business.
  • Processed transactions using a point-of-sale system.
  • Demonstrated product features and benefits for customers' needs.
  • Prepared product bundles
  • Helped customers find specific products, answered questions and offered product advice.
  • Engaged customers in friendly, professional dialogue to determine needs.

Education

Bachelor of Science - Psychology

Clayton State University

Skills

  • Document Workflow
  • Interpersonal and Written Communication
  • Policy Investigations
  • Claims Processing
  • Liability Determination
  • Claim Form Analysis
  • Property Damage Assessment
  • Escalation Management
  • Software Troubleshooting
  • Client Relationship Building
  • Data Entry
  • Computer Skills
  • Customer Service
  • Customer Retention
  • Data Processing

Additional Information - Skill Highlights

  • 7 Years' first-rate customer service experience
  • Strong verbal and writing skills
  • Knowledge of iOS, Android, and other mobile platforms
  • Excellent in analyzing legal documents and medical records
  • High problem-solving and organizational skills
  • Extensive experience in claims management and adjusting
  • Advanced understanding of HIPAA regulations

References

References available upon request.

Timeline

Claims Analyst

Towne Park, Ltd
01.2021 - Current

Retail Associate Manager

T-Mobile
09.2016 - 08.2021

Sales Associate

Journey's
01.2015 - 11.2017

Bachelor of Science - Psychology

Clayton State University

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ISIS SMITH