Jaime Smith
Fort Worth,TX
Summary
Resourceful and dedicated with excellent communication and relationship-building skills. Knowledgeable about health providers, procedures and plan benefits. Helps customers complete enrollments while minimizing stress and maximizing satisfaction with process and company. Advanced in Microsoft Office 365 products to include EXCEL, WORD, NOTE, and TEAMS.
Overview
10
10
years of professional experience
Work History
National Calls & Claims Trainer
CVS HEALTH CORPORATION
Arlington, TX
06.2018 - 12.2021
- Taught in-person and virtual courses to new hires and existing employees.
- Monitored participant workflow and behaviors throughout training process.
- Performed continuous evaluations of content and plans to enhance delivery and improve effectiveness.
- Implemented diverse instructional methods, optimizing trainee engagement.
- Identified and recommended staff for key positions and departments.
- Implemented new training courses after assessing corporate data and identifying employee weaknesses.
- Tracked attendance and evaluated progress for assigned trainees.
- Monitored and reported trainee progress, introducing new learning tools to address individual needs.
- Developed effective training plans based on department needs and objectives.
- Prepared and presented supplementary learning material to support structured lessons.
Health Concierge for Member Services
Aetna
Arlington, TX
01.2014 - 06.2018
- Helped members navigate enrollment process and choose appropriate options.
- Assisted individuals, families and small businesses with acquiring health, vision, life and dental insurance.
- Maintained full and current understanding of available plans, products and services.
- Handled more than 40 daily inbound calls from health plan customers.
- Provided information such as eligibility, copay, deductible, benefit details, pre-approval procedures, and appeal options.
- Resolved problems related to benefits, eligibility and claims.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Followed document protocols to safeguard confidentiality of patient records.
Provider Services Representative
Aetna
Arlington, TX
06.2012 - 01.2014
- Increased efficiency and team productivity by promoting operational best practices..
- Cross-trained and provided backup support for organizational leadership.
- Provided primary support to medical provider by verifying eligibility and providing claim status.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- provided insurance verification of eligibility, claim status, appeal status, and updated provider account information.
- Actively listened to providers, handled concerns quickly and escalated major issues to supervisor.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Clarified provider issues and determined root cause of problems to resolve complaints.
Education
Bachelor of Science - Criminal Justice
Jackson State University
Jackson, MS08.2008
High School Diploma -
Irmo High School
Columbia, SC06.1996
Skills
- Coaching and mentoring
- Review of contracts
- Database Management
- Analytical problem solver
- Business development and planning
- Inbound and Outbound Calling
- Report preparation
- Complaint resolution
- Service standard compliance
- Administrative support
- Technical Support
- Medical terminology knowledge
- Professional telephone demeanor
- Account management
- Creative problem solving
- Multi-line phone talent
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
The way to get started is to quit talking and begin doing.
Walt Disney
Timeline
National Calls & Claims Trainer
CVS HEALTH CORPORATION
06.2018 - 12.2021
Health Concierge for Member Services
Aetna
01.2014 - 06.2018
Provider Services Representative
Aetna
06.2012 - 01.2014
Bachelor of Science - Criminal Justice
Jackson State University
High School Diploma -
Irmo High School