Karen Simon
Covington,GA
Summary
Dynamic administrative professional and leader with 20+ years of experience playing key role in attaining daily objectives and long-term goals across diverse office platforms. Excel in timely and accurate processing of accounts payable and receivable and applying advanced analytical acumen. Strongly committed to raising productivity and service quality via strategic planning and allocation of resources as well as implementation of process improvements. Skilled medical claims processor and liaison with superior communication, computer, support and organizational skills.
Overview
14
14
years of professional experience
Work History
Administrative Support 2
GA Division Of Family And Children Service
06.2022 - Current
- Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Executed record filing system to improve document organization and management.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Developed and updated spreadsheets and databases to track, analyze, and report on performance and sales data.
- Created and maintained databases to track and record customer data.
- Coordinated and scheduled meetings and conference calls to optimize scheduling of senior staff.
- Assisted development and implementation of new administrative procedures.
- Sorted and distributed office mail and recorded incoming shipments for corporate records.
- Developed strategies to streamline and improve office procedures.
- Negotiated contracts with vendors and suppliers for office supplies, equipment and services.
- Managed department budgets and generated financial reports for management review.
- Managed filing system, entered data and completed other clerical tasks.
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
- Assisted coworkers and staff members with special tasks on daily basis.
- Managed paper and electronic filing systems by routing various documents, taking messages and managing incoming and outgoing mail.
- Built and maintained excellent customer relationships through timely response to inquiries and going above and beyond to accommodate unusual requests.
- Created and maintained detailed administrative processes and procedures to drive efficiency and accuracy.
- Continually sought methods for improving daily operations, communications with clients, recordkeeping and data entry for increased efficiency.
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
- Volunteered to help with special projects of varying degrees of complexity.
- Established administrative work procedures to track staff's daily tasks.
- Identified and recommended changes to existing processes to improve accuracy, efficiency, and quality service.
- Liaised between clients and vendors and maintained effective lines of communication.
- Recorded new hires, transfers, terminations, changes in job classifications and merit increases to main human resources files.
- Increased office participation in special events by creating newsletter with detailed calendars and other office updates.
Customer Experience Specialist
Delta Airlines
10.2021 - 06.2022
- Utilized telephone, online chat, and email platforms to deliver outstanding customer service.
- Responded to high volume of incoming calls utilizing listening and communication skills to identify customer problems, needs, and opportunities.
- Addressed customer inquiries, concerns, and complaints by providing solutions and alternatives and followed up to confirm resolution.
- Documented customer interactions in internal database to maintain customer service history details.
- Maintained extensive knowledge of company products to recommend items aligned with customer needs.
- Resolved customers' issues related to online purchases, late product deliveries and billing discrepancies to encourage good customer relationships.
- Engaged in cross-selling and up-selling activities to enhance customers' experiences and generate revenue.
- Collaborated with internal team members to resolve customer concerns and deliver enhanced customer experiences.
- Cooperated closely with other departments to support achievement of customer experience outcomes.
- Monitored customer feedback to identify areas of improvement in customer experience.
- Investigated customer complaints and escalated issues to address critical requests.
- Adhered to established customer satisfaction strategies to support swift issue resolution.
- Maintained key performance indicators and acceptable performance levels to support assigned customer base.
- Enhanced industry and technical knowledge through active participation in learning and growth opportunities.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Investigated and resolved customer inquiries and complaints quickly.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Delivered prompt service to prioritize customer needs.
- Met customer call guidelines for service levels, handle time and productivity.
- Maintained up-to-date knowledge of product and service changes.
- Responded proactively and positively to rapid change.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Followed up with customers about resolved issues to maintain high standards of customer service.
Engagement Specialist
View Point Mental Health/Rockdale Outpatient Center
03.2018 - 10.2021
- Successfully manage and improve relationships between the Clients and the Rockdale Center
- Established measurable standards to guide continual improvement and increased Client engagement and retention.
- Generated monthly reports pertaining to Grants received for medication and transportation.
- Created and sent service invoices to Rockdale Courts for payment.
- Monitored and maintained clinician’s caseloads by discharging non-active clients.
Program Assistant
View Point Mental Health/Rockdale Outpatient Center
01.2016 - 03.2018
- Provided professional, courteous, time-efficient, client-centered, and accurate administrative support required to facilitate client care
- Registered patients accurately and schedule medical and counseling appointments; input client information into the computer system and obtain necessary authorizations and verify insurance eligibility
- Completed all required financial paperwork necessary to assure prompt and accurate payment from client’s insurance carriers
- Assured that all required procedures at discharge were followed such as, patient information reconciliation to maintain accurate record, and ensure proper signage of all forms.
- Managed data and correspondence to secure information across complex landscapes of organizational departments.
- Proofread and edited documents for accuracy and grammar.
- Drafted common document templates to reduce time spent creating documents from scratch.
- Increased customer service success rates by quickly resolving issues.
- Streamlined office operations by effectively monitoring and addressing client correspondence and data communications.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Performed wide-ranging administrative, financial and service-related functions.
- Completed daily logs for management review.
- Volunteered to help with special projects of varying degrees of complexity.
- Followed detailed directions from management to complete daily paperwork and computer data entry.
- Offered technical support and troubleshot issues to enhance office productivity.
- Authored business documents to organize and emphasize information quickly and effectively.
- Identified communication channels to set roadmap to distribute information.
- Delivered top-notch administrative support to office staff, promoting excellence in office operations.
- Created and updated records and files to maintain document compliance.
- Prepared clearly written and formatted documents and reports.
- Managed both digital and physical filing systems and retrieved documents as required.
Program Assistant
View Point Mental Health/C&A CSU
07.2015 - 01.2016
- Provided professional, courteous, time-efficient, client-centered, and accurate administrative support required to facilitate client care
- Monitored the GCAL Crisis Board for possible admissions to C&A CSU
- Reviewed Emergency Room documents with Charge Nurse and MD on duty to determine eligibility for admission
- Obtained placement for underage individuals on the GCAL board to an age-appropriate facility
- Registered patients accurately and promptly per triage level; input client information into the computer system and obtain necessary authorizations and verify insurance eligibility
- Performed required procedures at discharge: patient information reconciliation, maintain accurate record to reflect all related transactions; ensure proper signage of all forms.
- Assisted with planning and coordinating day-to-day and special program activities.
- Managed both digital and physical filing systems and retrieved documents as required.
- Prepared clearly written and formatted documents and reports.
- Created and updated records and files to maintain document compliance.
- Completed daily logs for management review.
- Performed wide-ranging administrative, financial and service-related functions.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Trained and supervised employees on office policies and procedures.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Increased customer service success rates by quickly resolving issues.
- Proofread and edited documents for accuracy and grammar.
Claims Examiner
HealthFirst NY
03.2014 - 06.2015
- Reviewed, investigate and adjudicate claims and encounters for medical services through contractual provisions in accordance with provider contracts and authorizations
- Processed new claim suspensions and reprocess (as needed) for discrepancies, as well as review other documentation for edits and consistency
- Absorbed, retained, and applied a wide range of information about the company policies, procedures, and benefits
- Met individual and department standards with regards to both quality and productivity goals.
- Maintained suspicious claims database and prepared reports for supervisors.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Documented information gathered and uploaded data to company database for efficient processing.
Claims Analyst
Employee Benefit Solutions/Difference Card
07.2009 - 03.2014
- Entered and processed client's employee's Medical, Flexible Spending and Dependent Care and Transportation account reimbursements in an accurate and timely manner
- Analyzed and processed reimbursements within a client's contract parameters
- Viewed reports regularly to make sure processing was conducted efficiently.
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Identified key areas not performing well and implemented effective, new processes.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Examined claims forms and other records to determine insurance coverage.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Researched claims and incident information to deliver solutions and resolve problems.
- Followed up with insured individuals regarding premium and deductibles payments.
- Assisted Customer Service and Enrollments departments during high call and enrollment volumes on an as needed basis.
- Maintained strict confidentiality with all personal data as per company guidelines.
Sales Associate/Beauty Advisor
Macy's
04.2010 - 08.2013
- Helped customers locate products and checked store system for merchandise at other sites.
- Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
- Prepared merchandise for sales floor by pricing or tagging.
- Rotated stock and restocked shelves to maintain product availability and store appearance.
- Managed returns, exchanges and refunds in accordance with store policy.
- Answered customer questions about sizing, accessories, and merchandise care.
- Maintained calm demeanor and professionally managed issues in busy, high-stress situations.
- Provided positive first impressions to welcome existing, new, and potential customers.
- Engaged with customers to build rapport and loyalty.
- Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.
- Solved customer challenges by offering relevant products and services.
- Assessed customer needs and utilized suggestive selling techniques to drive sales.
- Engaged with customers to effectively build rapport and lasting relationships.
- Educated clients on current promotional offerings and products using persuasive selling tactics.
- Generated new sales leads to achieve and exceed monthly sales goals.
- Stocked merchandise, clearly labeling items, and arranging according to size or color.
- Answered customer questions about products and services, helped locate merchandise, and promoted key items.
- Engaged in friendly conversation with customer to better uncover individual needs.
- Listened to customer needs and desires to identify and recommend optimal products.
- Managed efficient cash register operations.
- Opened, shelved and merchandised new products in visually appealing and organized displays for optimal sales promotions.
- Built customer loyalty and retention by delivering excellent shopping experiences.
- Created inviting environment for customers by maintaining store organization and cleanliness.
- Delivered energetic responses to customers in-store and by telephone, going above and beyond to serve needs.
- Volunteered for extra shifts during holidays and other busy periods to alleviate staffing shortages.
- Provided exceptional services and pleasant shopping experiences to retail customers.
- Developed strong rapport with customers and created positive impression of business.
- Maintained up-to-date knowledge of store sales, payment policies and security standards.
- Used in-store system to locate inventory and place special orders for customers.
- Recommended complementary purchases to customers, increasing revenue.
- Monitored customers for signs of security concerns and escalated issues to management.
- Prioritized helping customers over completing other routine tasks in store.
- Worked to meet or exceed special targets for credit card applications, special donations and specific product promotions.
Education
Bachelor of Arts - Psychology
Gwinnett College
Lawrenceville, GA05.2025
High School Diploma -
Erasmus Hall High School
Brooklyn, NY06.1989
Skills
- Medical terminology
- Vital Signs
- Medical Office Experience
- Medical Claims Processing
- Accounts Payable
- Accounts Receivable
- Typing (40-50 wpm)
- Switchboard
- Medical Billing
- Notary Public
- Microsoft Office (Word, Excel, PowerPoint, Outlook)
- Knowledge of Medical Terminology
- CPT, ICD-9, and ICD-10 codes
- Administrative Skills
- Organizational Skills
- Medical Scheduling
- Communication skills
- 10 Key Calculator
- Data Entry
- Behavioral Health
- Social Perceptiveness
- Meeting Support
- Inquiry Requests
- Dictation and Transcription
- Compliance Training
- Accounting Familiarity
- Complex Problem-Solving
- Postage Meter
- Administrative Procedures
- Strategic Planning
- Customer Care
- Office Equipment Operation
- Appointment Management
- Office Supplies and Inventory
- Training Junior Team Members
- Supply Inventory Control
- Clerical Support
- Document Quality
- Bilingual in Haitian Creole and English
- Administrative Support
- Active Learning
- Research and Analytical Skills
- Inventory Management
- Data Communications
- Customer Satisfaction
- Organize Files
- Team Support
- File Organization
Languages
Haitian Creole
Native or Bilingual
Timeline
Administrative Support 2
GA Division Of Family And Children Service
06.2022 - Current
Customer Experience Specialist
Delta Airlines
10.2021 - 06.2022
Engagement Specialist
View Point Mental Health/Rockdale Outpatient Center
03.2018 - 10.2021
Program Assistant
View Point Mental Health/Rockdale Outpatient Center
01.2016 - 03.2018
Program Assistant
View Point Mental Health/C&A CSU
07.2015 - 01.2016
Claims Examiner
HealthFirst NY
03.2014 - 06.2015
Sales Associate/Beauty Advisor
Macy's
04.2010 - 08.2013
Claims Analyst
Employee Benefit Solutions/Difference Card
07.2009 - 03.2014
Bachelor of Arts - Psychology
Gwinnett College
High School Diploma -
Erasmus Hall High School
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