Maelee Smith
Winter Haven,FL
Summary
Highly effective Medical Claims Processor with a proven track record of building strong rapport with providers to discuss claim status or claim denials. Equipped to handle multiple administrative tasks effectively. Possesses highly investigative skills when processing claims, ensuring accuracy and attention to detail. Detail-oriented team player with strong organizational skills and the ability to handle multiple projects simultaneously with a high degree of accuracy. Currently seeking a full-time position that offers professional challenges where interpersonal skills, excellent time management, and problem-solving abilities can be utilized. Known for organizational prowess and dependability, successfully manages multiple priorities with a positive attitude. Always willing to take on added responsibilities to meet team goals.
Overview
8
8
years of professional experience
Work History
Auto Medical Claims Associate
State Farm
04.2022 - 08.2024
- Contributed to positive work environment through effective communication with team members and supervisors.
- Maintained high level of industry knowledge by participating in continuing education programs, staying informed on changing regulations and best practices.
- Enhanced customer satisfaction by efficiently managing and resolving auto claims in timely manner.
- Provided exceptional customer service by addressing inquiries promptly and professionally, resulting in improved client relationships.
- Managed high volume of daily claims while maintaining accuracy and organization, leading to increased productivity levels.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Improved claim processing efficiency by conducting thorough reviews of medical claims and identifying discrepancies.
Medical Records Clerk
Eye Specialists of Mid Florida
01.2017 - 03.2021
- Keep records of materials filed or removed, using logbooks or computers
- Add new material to file records or create new records as necessary
- Perform general office duties such as typing, operating office machines, and sorting mail
- Track materials removed from files to ensure that borrowed files are returned
- Gather materials to be filed from departments or employees
- Sort or classify information according to guidelines, such as content, purpose, user criteria, or chronological, alphabetical, or numerical order
- Find and retrieve information from files in response to requests from authorized users
- Scan or read incoming materials to determine how and where it should be classified or filed
- Answer questions about records or files
- Eliminate outdated or unnecessary materials, destroying them or transferring them to inactive storage, according to file maintenance guidelines or legal requirements
- Place materials into storage receptacles, such as file cabinets, boxes, bins, or drawers, according to classification and identification information
- In charge of putting together patient charts for the next day for the doctors
- Scan in all documents that come back from all departments and doctors
- Answer phone calls when patients call for records and/or help them figure out the person they need to talk to.
- Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
Cashier/Customer Service
Publix
11.2018 - 10.2020
- Receive payment by cash, check, credit cards, vouchers, or automatic debits
- Issue receipts, refunds, credits, or change due to customers
- Assist customers by providing information and resolving their complaints
- Greet customers entering establishments
- Answer customers' questions, and provide information on procedures or policies
- Maintain clean and orderly checkout areas and complete other general cleaning duties, such as mopping floors and emptying trash cans
- Stock shelves, and mark prices on shelves and items
- Count money in cash drawers at the beginning of shifts to ensure that amounts are correct and that there is adequate change
- Sort, count, and wrap currency and coins
- Establish or identify prices of goods, services or admission, and tabulate bills using calculators, cash registers, or optical price scanners
- Supervise others and provide on-the-job training.
- Greeted customers entering store and responded promptly to customer needs.
- Welcomed customers and helped determine their needs.
Cashier Team Member
Chick-Fil-A
09.2016 - 12.2016
- Receive payment by cash, check, credit cards, vouchers, or automatic debits
- Issue receipts, refunds, credits, or change due to customers
- Assist customers by providing information and resolving their complaints
- Greet customers entering establishments
- Answer customers' questions, and provide information on procedures or policies
- Maintain clean and orderly checkout areas and complete other general cleaning duties, such as mopping floors and emptying trash cans
- Stock shelves, and mark prices on shelves and items
- Count money in cash drawers at the beginning of shifts to ensure that amounts are correct and that there is adequate change
- Sort, count, and wrap currency and coins
- Establish or identify prices of goods, services or admission, and tabulate bills using calculators, cash registers, or optical price scanners
- Supervise others and provide on-the-job training.
- Restocked and organized merchandise in front lanes.
Education
Associate of Arts -
Polk State College
Winter Haven, FL07.2021
High School Diploma -
Winter Haven High School
Winter Haven, FL06.2016
Skills
- HIPAA compliance awareness
- Medical Coding Expertise
- ICD-10-CM Understanding
- Insurance Verification
- Knowledgeable in Workday
- Knowledgeable in ECS
- Knowledgeable in SalesForce
- Medical Office Experience
- Organized and can multi-task
- Dependable and enthusiastic
- Hardworking and punctual
- Adaptable and flexible
- Proficient in Microsoft Office programs
Assessments
- Administrative Assistant/Receptionist, Proficient, 08/01/20, Using basic scheduling and organizational skills in an office setting.
- Sales skills, Proficient, 04/01/21, Influencing and negotiating with customers
- Attention to detail, Proficient, 04/01/21, Identifying differences in materials, following instructions, and detecting details among distracting information
- Work style: Conscientiousness, Proficient, 04/01/21, Tendency to be well-organized, rule-abiding, and hard-working
- Data entry: Accuracy, Expert, 04/01/21, Entering data quickly and accurately
Hobbies and Interests
Very interested and open minded to learning new things.
Timeline
Auto Medical Claims Associate
State Farm
04.2022 - 08.2024
Cashier/Customer Service
Publix
11.2018 - 10.2020
Medical Records Clerk
Eye Specialists of Mid Florida
01.2017 - 03.2021
Cashier Team Member
Chick-Fil-A
09.2016 - 12.2016
Associate of Arts -
Polk State College
High School Diploma -
Winter Haven High School