Kelly Marie Smith
New Braunfels ,TX
Summary
Accomplished insurance professional with extensive experience,, adept at building client relationships and exceeding sales targets. Skilled in policy writing and cross-selling, with a strong understanding of insurance regulations. Licensed in all 50 states, leveraging active listening and negotiation skills to deliver tailored insurance solutions. Consistently recognized for achieving personal quotas.
Overview
9
9
years of professional experience
Work History
Insurance Agent
Progressive
11.2018 - 05.2024
- Sr. Specialty Agent
- Appointed with 9 carriers and licensed in all 50 states including Washington DC.
- Utilized KMS guidelines for each state and carrier to ensure proper coverage.
- Built relationships with clients using active listening. Educated clients on insurance coverage and policy.
- Determined client needs and selecting the right carrier to write the policy for the clients situation. Identified potential risks and recommended appropriate insurance coverage.
- Utilized CRM software to manage client relationships. Utilized docusign to sign contracts for Umbrella coverage.
- Cross-sold insurance products to existing clients to reach sales targets.
- Negotiated with insurance underwriters to obtain coverage for clients.
- Monitored changes in insurance guildlines to stay compliant with carriers, laws and regulations.
- Worked with the sales team to collaboratively reach targets, consistently meeting or exceeding personal quotas.
- Participated on the Specialty Advisory Board with my CRM manager and our process specialist. Clarified and helped correct processes by providing feedback from team members and coworkers.
Health Insurance Intake Representative
Evicore
10.2017 - 11.2018
- Utilization management for several health care insurance providers.
- Communicated with physicians, patients, and facilities processing requests for insurance authorization ensuring complete and accurate information.
- Built case by entering the demographic and medical information and followed health plan guidelines.
- Documented patient medical information, ICD-10 codes, and insurance details to facilitate authorization for diagnosis modalities, treatments, and medical procedures.
- Coordinated referrals through insurance and other medical specialists.
- Provided status updates, revisions to cases and authorizations.
Medical Claims Examiner
United Healthcare Group
05.2015 - 01.2016
- Reviewed UB claims for hospitals, ambulatory surgical centers, skilled nursing facilities and home health care.
- Identified insurance coverage through examination of claims documentation and related records.
- Paid or denied medical claims based upon established claims processing criteria.
- Reviewed provider coding information to report services and verify correctness. Reviewed edits on the claim by folllwing the appropriate process instructions on the edit.
- Used CMS- Centers for Medicare and Medicaid guidelines as resource to process medical claims.
- Maintained knowledge of claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Monitored and updated claims status in claims processing system.
- Assessed medical claims for compliance with regulations and timely filing. Deny claim or line deny service that does not meet criteria.
- Determined pricing for claims requiring manual pricing. Calculated co-pays and deductibles.
Education
Licensed Producer
Progressive
Medical Coder Training Certificate
Georgia Emergency Associates
Medical Claims Examiner Training Certificate
United Health Care
Skills
- Licensed Insurance Agent- Texas producer license #2372104
- Quotes, policy writing and sales
- Property insurance, homeowners, renters, mobile home and umbrella
- Auto insurance and special lines
Timeline
Insurance Agent
Progressive
11.2018 - 05.2024
Health Insurance Intake Representative
Evicore
10.2017 - 11.2018
Medical Claims Examiner
United Healthcare Group
05.2015 - 01.2016
Licensed Producer
Progressive
Medical Coder Training Certificate
Georgia Emergency Associates
Medical Claims Examiner Training Certificate
United Health Care