Nashaundra Smith
Lawrenceville,GA
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
12
12
years of professional experience
Work History
Employment Specialist
AT&T
08.2017 - 01.2021
- Completed human resource operational requirements by scheduling and assigning employees.
- Developed disaster and recovery strategy to prepare company for hazardous weather conditions, nuclear accidents and terrorist attacks.
- Updated client records to reflect personal information, qualifications and career aspirations.
- Established strong relationships with local employers to match clients with suitable job opportunities.
- Conducted performance reviews and provided feedback to managers on employee performance.
- Conducted assessments, interviews, and job trials with clients to develop person-centered plans for employment and support.
Customer Service Representative
Amazon
04.2020 - 11.2020
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Responded to customer requests for products, services, and company information.
- Investigated and resolved customer inquiries and complaints quickly.
HEDIS SERVICE ASSOCIATE
Hedis
11.2015 - 02.2018
- Enhanced customer satisfaction by providing timely and efficient assistance in various service tasks.
- Maintained accurate records of customer interactions, ensuring consistency in service delivery.
- Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
- Maintained effective communication with project leader and utilized initiative, problem-solving skills and the ability to adapt quickly to change
- Copied, sorted and uploaded previously scanned information to Macess.
- Oversee incoming and outgoing fax documents, assisted with provider clean up. Scheduled Medical, Dental and Trauma assessments for GA Families foster children
Authorization Specialist
Benevis
04.2017 - Current
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Pull authorization request from PA/OCR queue
- Update of Queue on prior auth status
- Submission of post authorizations
Field Reviewer
Hire Dynamics
01.2015 - 07.2015
- Sorted and distributed incoming and outgoing medical records.
- Collaborated with team members to conduct joint inspections, resulting in a more thorough assessment of properties.
- Proprietary programs including Project Management (OPM) and Customer Records Management (CRM) software to document calls and information.
- Completed cross training in document management
Customer Service Representative
Delta Dental Insurance
10.2011 - 08.2013
- Educated customers about billing, payment processing, claims and support policies and procedures.
- Resolved associate, tool and service delivery issues revealed by statistical reports.
- Attained and maintained quality qualifications and adherence to production metrics. Supported HMO Delta Care as a Data Entry Operator researching.
Education
Associate of Science - Business Administration
Gwinnett College
Lilburn, GA10.2010
Certificate - Accounting
Gwinnett College
Lilburn, GA04.2005
Skills
- Recruitment and hiring
- Microsoft Office
- Claims
- Insurance processing
Timeline
Customer Service Representative
Amazon
04.2020 - 11.2020
Employment Specialist
AT&T
08.2017 - 01.2021
Authorization Specialist
Benevis
04.2017 - Current
HEDIS SERVICE ASSOCIATE
Hedis
11.2015 - 02.2018
Field Reviewer
Hire Dynamics
01.2015 - 07.2015
Customer Service Representative
Delta Dental Insurance
10.2011 - 08.2013
Associate of Science - Business Administration
Gwinnett College
Certificate - Accounting
Gwinnett College
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