Kailyn Smith
Porter,TX
Summary
Highly skilled Service Specialist with background in customer support and service management. Demonstrate strong communication skills, problem-solving abilities, and knowledge of industry best practices. Notable for enhancing customer satisfaction levels and improving operational efficiency in previous roles. High level of competence in handling complex tasks, delivering quality results, and contributing positively to team environments.
Overview
9
9
years of professional experience
Work History
Service Specialist
Wellsense (remote)
Boston, MA
10.2022 - Current
- Processed claims accurately in claims management systems and kept required documentation current.
- Improved customer satisfaction by sharing timely, accurate claim status and resolution updates.
- Communicated with policyholders, providers, and internal teams to clarify claim details and next steps.
- Consistently met or exceeded service quality, response time, and customer satisfaction goals.
- Investigated and resolved customer inquiries and complaints quickly.
- Verified eligibility and authorization compliance for service providers.
- Answered healthcare provider questions about prior authorization requests.
- Reviewed prior authorization requests for medical necessity, completeness, and payer compliance.
- Verified insurance coverage and updated patient account information in service records.
- Explained healthcare policies, benefits, and payment options in clear patient language.
- Provided customer service by answering inquiries, resolving complaints, and providing general information to clients regarding healthcare services.
- Resolved eligibility, billing, and coverage questions using insurance and patient records.
- Maintained confidentiality while handling sensitive patient information and account details.
Customer Service Representative/Assistant Trainer
All Web Leads (remote)
Austin, TX
08.2021 - 10.2022
- Engage in inbound and outbound calls with consumers looking to compare insurance rates. Ask them qualifying questions and encourage them to speak with one of the insurance agents in our network who will help them to purchase insurance.
- Make outbound follow up calls, inquiring about the consumer's purchasing experience and making sure their needs were met. Help consumers get connected with the right agent and record information about their purchasing experience.
- Provided training to new Customer Service Representatives Assistants when needed.
- Assisted managers in developing plans for enhancing customer relations initiatives.
Direct Support Supervisor
ResCare - Louisville, Kentucky
Louisville, KY
03.2020 - 04.2021
- Teach and assist individuals in all activities of daily living, include, but are not limited to personal hygiene including toileting, cooking, house cleaning, laundry, leading a healthy lifestyle, shopping, budgeting, maintaining appropriate behavior, and community integration.
- Instruction and documentation, participation in development and revisions of formal goals and protocols in accordance with the CFA/ISP, and behavior plans.
- Trained and supervised staff in providing quality care to individuals with disabilities.
- Monitored the health and safety of all individuals in the program through regular visits, assessments, and documentation.
Front End Supervisor
Ross Dress for Less
Beaumont, TX
06.2017 - 12.2019
- Developed and implemented strategic plans for front end operations to ensure customer satisfaction.
- Maintained accurate records of inventory, sales, and employees.
- Trained new employees in customer service techniques and store policies.
- Provided excellent customer service in a fast- paced retail environment.
Education
Rocky River High School
Charlotte, NCCertificate - Medical Assisting
Martinsburg College
Martinsburg, WV 02.2022 - 08.2022
Skills
- Computer proficiency
- Multi-task management
- Data entry
- Claims processing
- Precertification requirements
- Customer service
- Inbound and outbound calling
- Eligibility verification
- Attention to detail
- Clear communication
- Time management
- Microsoft Excel
- Team leadership
- Team collaboration
- Insurance claims handling
- Claims research
- Prior authorization
- Patient account review
- Typing proficiency
- Prioritization
- Multitasking and organization
- Verbal and written communication
- Medical terminology
Timeline
Service Specialist
Wellsense (remote)
10.2022 - Current
Certificate - Medical Assisting
Martinsburg College
02.2022 - 08.2022
Customer Service Representative/Assistant Trainer
All Web Leads (remote)
08.2021 - 10.2022
Direct Support Supervisor
ResCare - Louisville, Kentucky
03.2020 - 04.2021
Front End Supervisor
Ross Dress for Less
06.2017 - 12.2019
Rocky River High School