Shari Smith
Appeals and Grievance Coordinator
Wheelersburg,OH
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
26
26
years of professional experience
Work History
Grievance and Appeals Coordinator
Highmark Health Inc.
614 Market St, WV
09.2013 - 08.2023
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Communicating with members, scanned documents.
- Coordinated with senior specialist to compose appeal responses.
- Reviewed Benefits, and Medical Polices.
Manager
CATO Fashions
605 Grand Central Vienna, WV 26105
03.2011 - 08.2013
- Accomplished multiple tasks within established timeframes.
- Onboarded new employees with training and new hire documentation.
- Cross-trained existing employees to maximize team agility and performance.
- Maximized performance by monitoring daily activities and mentoring team members.
- Evaluated employees' strengths and assigned tasks based upon experience and training.
- Adjusted job assignments and schedules to keep pace with dynamic business needs, factoring in processes, employee knowledge and customer demands.
- Developed and maintained relationships with customers and suppliers through account development.
- Established and updated work schedules to account for changing staff levels and expected workloads.
- Delivered feedback to decision-makers regarding employee performance and training needs.
- Recorded inventory sales into organization's weekly income report.
- Maximized productivity by keeping detailed records of daily progress and identifying and rectifying areas for improvement.
Administrative Associate
Select Staffing @ Kraton Polymers
College Parkway, Parkersburg WV
06.2005 - 10.2011
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Drafted professional memos, letters and marketing copy to support business objectives and growth.
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities and communicate instructions.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Developed and updated spreadsheets and databases to track, analyze and report on performance and sales data.
- Coordinated travel arrangements by booking airfare, hotel and ground transportation.
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
- Assisted coworkers and staff members with special tasks on daily basis.
- Managed filing system, entered data and completed other clerical tasks.
- Built and maintained excellent customer relationships through timely response to inquiries and going above and beyond to accommodate unusual requests.
- Completed forms, reports, logs and records to quickly handle all documentation for human resources.
- Maintained daily reports and advised executive leaders in decision-making processes.
- Volunteered to help with special projects of varying degrees of complexity.
Loss Prevention
Tj Maxx Dept Store
Grand Central Ave, Vienna WV 26105
10.2010 - 03.2011
- Attentively monitored store and surrounding areas for signs of attempted theft by customers or personnel, intervening when necessary.
- Calmly and efficiently addressed emergency situations such as safety hazards and threats to life or property, deescalating when possible and directing shoppers to safety.
- Upheld strict security and safety procedures to protect business from financial losses due to theft or careless mismanagement.
- Generated comprehensive reports documenting evidence of attempted theft and recovered merchandise.
Administrative Assistant
Merchants 5 Star
Route 7 Marietta Ohio 45750
11.2004 - 05.2005
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Executed record filing system to improve document organization and management.
- Scheduled office meetings and client appointments for staff teams.
- Sorted and distributed office mail and recorded incoming shipments for corporate records.
- Developed and updated spreadsheets and databases to track, analyze and report on performance and sales data.
- Processed invoices and expenses using QuickBooks to facilitate on-time payment.
Administration Assistant
Kelly Staffing \ Crescent & Sprague
Grand Central Vienna, WV 26105
08.2003 - 08.2004
- Developed and updated spreadsheets and databases to track, analyze and report on performance and sales data.
- Worked with supervisors and management to maintain status reports and update information for client projects.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Executed record filing system to improve document organization and management.
- Sorted and distributed office mail and recorded incoming shipments for corporate records.
Accounts Receivable Specialist
Broughton's Foods Company
Marietta, OH
07.2001 - 08.2003
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Prepared and mailed invoices to customers, processed payments and documented account updates.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Performed targeted collections on past due accounts aged over 30 days.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
- Researched and resolved customer claims related to shortages, discount violations and returns.
- Managed monthly reconciliation schedules for assigned accounts.
- Applied more than 100 payments per week.
- Responded to inbound inquiries regarding accounts and payments.
- Submitted cash and check deposits and generated cash receipts to record money received.
- Investigated daily variances and corrected errors to resolve discrepancies.
- Used accounting software to reconcile accounts, track income and generate invoices.
Receptionist, Purchashing, Accounts Receivable,
Benson Manufacturing Inc.
Mineral Wells, WV
12.1997 - 07.2001
- Answered large volume of incoming calls daily to resolve customer issues and schedule appointments.
- Answered central telephone system and directed calls accordingly.
- Checked-in visitors, distributed visitor badges and managed logbooks to comply with security initiatives.
- Supported various administrative duties by proofreading, transcribing and invoicing.
- Scheduled and confirmed appointments and meetings for senior management team.
- Triaged incoming calls on multi-line phone system and directed to departments based on customer needs.
- Coordinated travel accommodations, agenda, and transportation for staff and out-of-town visitors.
- Managed multi-line phone system directing individuals to desired personnel and providing general information about operations.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Provided clerical support to company employees by copying, faxing and filing documents.
- Sorted, received and distributed mail correspondence between departments and personnel.
- Monitored and screened visitors to verify accessibility to inter-office personnel.
- Liaised with vendors, contractors and professional services personnel to properly process orders.
- Managed multiple tasks and met time-sensitive deadlines.
- Received and routed business correspondence to correct departments and staff members.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Summarized receivables by maintaining invoice accounts, coordinating monthly transfer to accounts receivable account, verifying totals and preparing reports.
Education
No Degree - Business
WVUP
Parkersburg, WV01.2011
High School Diploma -
Williamstown High School,
Williamstown, WV05.1980
Skills
- Communications Strategies
- Active Listening
- Medicare Compliance
- Organization and Prioritizing Tasks
- Complex Problem-Solving
- HIPAA Guidelines
- CMS Guidelines
- Microsoft Office
- Medical Records Research
- Office Support
- Appeals Support
- Customer Feedback
Timeline
Grievance and Appeals Coordinator
Highmark Health Inc.
09.2013 - 08.2023
Manager
CATO Fashions
03.2011 - 08.2013
Loss Prevention
Tj Maxx Dept Store
10.2010 - 03.2011
Administrative Associate
Select Staffing @ Kraton Polymers
06.2005 - 10.2011
Administrative Assistant
Merchants 5 Star
11.2004 - 05.2005
Administration Assistant
Kelly Staffing \ Crescent & Sprague
08.2003 - 08.2004
Accounts Receivable Specialist
Broughton's Foods Company
07.2001 - 08.2003
Receptionist, Purchashing, Accounts Receivable,
Benson Manufacturing Inc.
12.1997 - 07.2001
No Degree - Business
WVUP
High School Diploma -
Williamstown High School,
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