Korin A. Smith
Bridgewater,NJ
Summary
Dynamic and motivated professional seeking to contribute to a reputable organization while fostering personal and professional growth. Eager to leverage skills to drive success and support the achievement of organizational goals. Committed to continuous learning and performance excellence, ensuring valuable contributions that align with the company's vision. Proactive team player ready to tackle challenges and deliver results in a fast-paced environment.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Account Benefit Manager
Horizon Blue Cross Blue Shield of New Jersey
2016.08 - Current
- Interpret and record benefit and account profile data to ensure accurate client servicing and effective downstream system integration.
- Manage benefits processes to ensure seamless integration for groups with over 51 members.
- Facilitate the correct implementation of groups throughout the entire process to support operational efficiency.
- Oversee account setup and resolve enrollment, claim, and billing issues within first month to support client onboarding process.
- Achievd seamless implementation of benefit changes for existing clients through effective collaboration with account management teams and internal departments. Drove the launch of new lines of business. Resolve benefit-related issues promptly, improving overall service delivery.
- Facilitate off-site client meetings to review benefit documentation. Provided recommendations for changes and discussed cost-saving factors. Assist clients in validating proposed adjustments.
- Conduct thorough pre- and post-implementation audits to identify areas for improvement and ensure project success.
- Collaborate with brokers and group administrators to design and implement tailored benefits for large group clients.
Team Leader/Coordinator
Horizon Blue Cross Blue Shield of New Jersey
2010.09 - 2016.08
- Oversaw daily staff operations to guarantee exceptional customer service delivery.
- Coordinated and managed claims inventory, enhancing operational efficiency and service delivery.
- Executed daily receipt processing in alignment with established service level agreements (SLAs).
- Managed logistics and agenda for weekly team meetings, fostering a productive environment for discussion and decision-making.
- Conducted evaluations of staff competencies, focusing on strengths and areas for improvement.
- Delivered targeted coaching and mentoring to business team, enhancing staff performance and improving attendance metrics.
- Implemented initiatives to encourage a positive and inclusive work atmosphere.
- Conducted data analysis to inform decision-making and enhance operational efficiency.
- Organized and delivered targeted training workshops for internal employees and external partners.
- Developed and instituted new workflows aimed at streamlining operations and improving productivity.
Senior Member Services Coordinator
Horizon Blue Cross Blue Shield of New Jersey
2007.01 - 2010.09
- Selected for participation in the Monday Morning Leadership Program to enhance leadership skills and drive team success.
- Compiled and communicated essential medical claim details to physicians for efficient claims management.
- Supported customer service operations by supervising representative phone calls to enhance service quality.
- Conducted comprehensive training for customer service representatives, focusing on best practices and customer engagement techniques.
- Conducted thorough research and implemented solutions for escalated physician complaints, fostering positive relationships.
- Delivered comprehensive education to physicians regarding Horizon's medical policies and billing procedures to enhance compliance and operational efficiency.
- Developed workflows aimed at improving operational efficiency and business practices.
Principle Accounting Clerk
Rutgers, the State University of New Jersey
2004.07 - 2006.09
- Oversaw and facilitated all monetary transactions for the university, maintaining meticulous records and adherence to financial protocols.
- Guided students through transaction processes and clarified account information to enhance user experience.
- Managed refund check distribution to students, ensuring compliance with institutional policies.
- Supported supervisor in executing special projects to enhance operational efficiency.
- Guided students in establishing payment plans to support academic enrollment.
- Oversaw the timely processing of departmental deposits, facilitating efficient cash flow management.
Medical Assistant
Cardiovascular Interventionalists of Central Jersey
2003.01 - 2004.06
- Conducted thorough preparations for patient appointments, including vital sign monitoring and EKG administration.
- Coordinated documentation and communication for precertification to expedite project timelines and maintain quality assurance.
- Coordinated and supervised appointment scheduling to ensure timely client engagement.
- Handled and categorized phone inquiries to streamline response processes and enhance service delivery.
- Facilitated efficient office operations by overseeing all typing duties and patient registration activities.
Education
A.B.S - Counseling
Somerset Christian College
Zarepath, NJ2007-05
Skills
- Proficient in Nasco
- Claims resolution support
- Claims processing
- Enrollment confirmation
- Skilled in Microsoft Office tools
- Effective written communication
- Effective verbal communication
- Proficient in organization techniques
- Engaging telephone presentation skills
- Service excellence
- Client relationship management
Certification
NJ Health Producer License
Timeline
Account Benefit Manager
Horizon Blue Cross Blue Shield of New Jersey
2016.08 - Current
Team Leader/Coordinator
Horizon Blue Cross Blue Shield of New Jersey
2010.09 - 2016.08
Senior Member Services Coordinator
Horizon Blue Cross Blue Shield of New Jersey
2007.01 - 2010.09
Principle Accounting Clerk
Rutgers, the State University of New Jersey
2004.07 - 2006.09
Medical Assistant
Cardiovascular Interventionalists of Central Jersey
2003.01 - 2004.06
A.B.S - Counseling
Somerset Christian College