Melissa Smith
Brunswick,Ohio
Summary
- Proactive and goal-oriented with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth. Customer service professional with 28 years of experience, including 20 years in finance and 7 years in management roles
Overview
22
22
years of professional experience
Work History
Account Representative III
The Cleveland Clinic Foundation
Cleveland, OH
07.2019 - Current
- Serve as a resource for Ohio BWC billing, supporting team members with complex claims and escalations
- Review and submit medical bills to Ohio BWC, including resolution of challenging claims using critical thinking and advanced analysis.
- Monitored and analyzed denial trends, identifying root causes and reducing BWC provider ID-related denials by 75%
- Lead quality assurance efforts by maintaining personal QA standards and ensuring compliance with departmental goals.
- Balance and resolve patient accounts while prioritizing workflow to meet daily operational needs and deadlines.
- Communicate updates to Ohio BWC regulations and educate team members on policy changes and fee schedule updates.
- Provide ongoing support and guidance to Account Representatives, including troubleshooting and escalation management.
- Supported onboarding and training of new hires and developed Quick Reference Guides to promote consistency and efficiency
- Conducting Tier I and Tier II huddles during managements absence.
- Facilitate cross-departmental training with other departments on PDF Sam and Adobe Acrobat
- Lead and contribute to process improvement initiatives through Kaizen, implementing solutions that enhance operational efficiency.
- Managed key projects, including the Union Hospital BWC billing initiative and Ohio BWC Provider ID implementation.
- Collaborated with team members to support task completion and maintain an efficient workflow
- Actively contributed to process improvement initiatives and project work to enhance efficiency and workflows
Lead Customer Service Representative
Fifth Third Bank
Brecksville, Ohio
03.2016 - 05.2017
- Managed a team of 5 customer service representatives
- Supervised daily operations, ensuring compliance with banking regulations and policies.
- Reviewed associate performance to identify training needs.
- Conducted regular audits to ensure adherence to security protocols and cash management procedures.
- Implemented process improvements that reduced transaction times and increased customer satisfaction.
- Established positive relationships with clients through regular follow-ups and personalized service offerings.
Teller Manager
Citizens Bank
Brunswick, Ohio
03.2004 - 01.2016
- Managed cash flow and balanced cash drawers, minimizing discrepancies through meticulous audits.
- Supervised daily operations of teller line, ensuring adherence to policies and procedures.
- Ensured accurate organization and maintenance of legal records in compliance with bank retention schedules and regulatory guidelines
- Trained and mentored teller staff, enhancing customer service and operational efficiency.
- Collaborated with management to identify areas for process improvement, driving performance enhancement initiatives.
Education
No Degree - Nursing Coursework
Cuyahoga Community College
Parma Heights, OhioHigh School Diploma -
Brunswick High School
Brunswick, OH05-1998
Skills
- Hospital Billing Operations & Revenue Cycle Management
- Escalation Management & Issue Resolution
- Advanced Account Analysis, Root Cause Identification & Critical Thinking
- Quality Assurance (QA) Monitoring & Trend Analysis
- Process Improvement & Operational Efficiency Initiatives
- Training & Onboarding of New Team Members
- HIPAA Compliance & Data Privacy Standards
- Claims Processing & Denial Management
- Payer Guidelines & Compliance (Workers’ Compensation / BWC Billing Proficiency)
- Team Support & Cross-Functional Collaboration
Accomplishments
- RCM Caregiver of the Month September 2021
- RCM Professional Advisory Program
- Kaizen Card Recognition - Preventing HIPAA Violation
Timeline
Account Representative III
The Cleveland Clinic Foundation
07.2019 - Current
Lead Customer Service Representative
Fifth Third Bank
03.2016 - 05.2017
Teller Manager
Citizens Bank
03.2004 - 01.2016
No Degree - Nursing Coursework
Cuyahoga Community College
High School Diploma -
Brunswick High School