Summary
Overview
Work History
Education
Skills
Timeline
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Shaleigh Hurst

Shaleigh Hurst

Remote Professional
Springtown,TX

Summary

Focused remote professional seeking to gain valuable hands-on experience in a rewarding role. Passionate about detail and adept in applying analytical and critical thinking skills to solve complex problems and influence decision-making.

Proactive and goal-oriented professional 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.

Overview

25
25
years of professional experience

Work History

January 2022

Results CX
01.2022 - 06.2025
  • Self-motivated, with a strong sense of personal responsibility.
  • Worked effectively in fast-paced environments.
  • Skilled at working independently and collaboratively in a team environment.
  • Proven ability to learn quickly and adapt to new situations.

RESULTS CX
01.2022 - 06.2022
  • Responding to client benefit calls to provide benefit information.

BROADPATH SOLUTIONS
03.2020 - 05.2021
  • Assisting Medicare clients with claims filing and information.
  • Handled delivery of Covid 19 test results for patients in the state of Illinois.

CLAIMS SPECIALIST

Aetna
02.1997 - 10.2018
  • Acted as intermediary between insurance companies and customers, including researching and assessing information to determine validity of claims.
  • Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
  • Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims.
  • Researched coverage and premium options and supplied clients with best coverage available for individual needs.
  • Investigated and analyzed requirements to improve timeliness of reports to customers.
  • Delivered exceptional customer service to all clients by effectively communicating information and actively listening to concerns.
  • Uploaded documentation and reports to corporate database system using Cats, HLEL, Auto Coder, Rumba and ETUMS to facilitate smooth claims processing.
  • Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
  • Presented and clearly explained insurance policy options based on clients' needs and goals.
  • Coded claims forms and mediated disputes between carriers and clients.
  • Submitted up-to-date activity and production logs to agency management for review.
  • Reviewed, classified, coded and rated applications to support claims and appeals during busy periods.
  • Assisted customers with pre cert of inpatient admissions and surgical procedures via inbound calls.
  • Traveled between offices training new personnel on company computer systems and how to function in their individual work capacity.
  • Served on 5-member review panel for decision making to uphold or overturn customer appeals.

APARTMENT MANAGER

Twin Creek Apartments
01.1995 - 02.1997
  • Implemented business strategies to maximize tenant satisfaction and reduce vacancies.
  • Supervised and coordinated work of maintenance and cleaning personnel to optimize productivity and enhance results.
  • Developed strong, professional relationships with vendors and residents by initiating collaboration and delivering exemplary service and engagement.
  • Liaised between company and owners to address and remedy ongoing concerns.
  • Remained aware of all construction and maintenance projects and notified appropriate individuals of project updates, delays and schedule changes.
  • Coordinated maintenance and repair requests with Home office decision makers department and contacted contractors for bid proposals.
  • Managed overall tenant relations, including promoting tenant satisfaction and streamlining services delivery.
  • Achieved highest possible net operating income by implementing cost control and revenue improvement programs.
  • Inspected properties regularly to identify deficiencies and schedule repairs.
  • Compiled and conveyed all operational and financial data to regional manager.
  • Showed tenants around properties, highlighting features and redirecting concerns to capture interest.
  • Ensured timely production of annual rent, operating expense and real estate tax adjustments.
  • Coordinated necessary improvements in compliance with lease agreements to ensure timely completion, tenant acceptance, occupancy and rent commencement.
  • Verified property compliance with state and federal regulations avoiding any form of discrimination or illegal practices.
  • Recognized for fostering good working relationships with owners, residents and board members.
  • Inspected property every weekly, took pictures and wrote reports regarding findings for submission to owners.

Education

Medical Assistant - Medical Assisting

CTK Healthcare And Career Institute
Irving, TX
06.1991

High School Diploma - undefined

L D Bell High-school
Bedford, Texas
05.1990

Skills

  • Documentation review
  • Benefit explanation
  • Customer service and support
  • Investigation management
  • Policy analysis
  • Analyzing data
  • Negotiation proficiency
  • Self-motivated
  • Organized
  • Skilled negotiator
  • Excellent communication skills
  • Production-oriented
  • Thrives under pressure
  • Data collection
  • Complaint handling and resolution
  • Customer advocate
  • Organizational skills
  • Data Entry Specialist
  • Friendly, positive attitude
  • Teamwork and collaboration
  • Customer service
  • Problem-solving

Timeline

January 2022

Results CX
01.2022 - 06.2025

RESULTS CX
01.2022 - 06.2022

BROADPATH SOLUTIONS
03.2020 - 05.2021

CLAIMS SPECIALIST

Aetna
02.1997 - 10.2018

APARTMENT MANAGER

Twin Creek Apartments
01.1995 - 02.1997

High School Diploma - undefined

L D Bell High-school

Medical Assistant - Medical Assisting

CTK Healthcare And Career Institute

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