Tayler Smith
Muskogee
Summary
Experienced Medical Billing & Coding Graduate and Healthcare Administration professional with an Associate of Occupational Science Degree and Academic Honors. Currently serving as a Claims Adjustment Representative for UnitedHealth Group, successfully processing medical and dental claims for the past four years, both in an office setting and remotely from home. Throughout my career, I have received comprehensive training on various systems, including E&I queues, UNET system, COMET, MACESS, FACETS Reworkspace, and have gained valuable expertise through two years of hands-on experience within these systems.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medical Claims Adjuster
UnitedHealth Group
03.2022 - Current
- Acquired advanced skills through a structured 23-week processing training regimen.
- Validated correctness of processed claims.
- Handled daily volume of over 150 claims with consistent accuracy.
- Performed analysis of EOB, COB, and related information for timely updates.
- Executed disbursement of claims following outlined policy benefits.
- Streamlined claim workflows through effective routing and prioritization.
- Leveraged different Microsoft programs for seamless task management.
- Collaborated with secondary insurance providers.
- Analyzed policy details along with supporting documents provided by healthcare providers to make informed decisions on claims approvals or denials.
- Evaluated new software tools that improved productivity levels while maintaining accuracy standards.
- Managed high volume caseloads, prioritizing urgent and sensitive cases for immediate attention.
Clinical Outreach Coordinator
Aston Carter
10.2021 - 01.2022
- Conducted outreach efforts to connect members with insurance companies.
- Executed tasks with precision while adhering to remote work protocols.
- Facilitated seamless flow of communication through effective call management.
- Performed extensive daily outreach through high-volume phone calls.
- Coordinated appointment scheduling.
- Handled telephonic interactions with members.
Patient Care Coordinator
Dentures and Implant Solutions
01.2020 - 09.2021
- Handled financial transactions to ensure seamless service.
- Ensured timely and effective service delivery to individuals receiving medical attention.
- Employed different software types to enhance operations.
- Oversaw policy handling to support client satisfaction and risk management.
- Addressed customer inquiries via phone.
- Ensured accurate submission of all claims.
- Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery.
Clerk
Southeast Clinic Urgent Care
09.2019 - 02.2020
- Utilized strong multitasking skills to manage multiple priorities and tasks, ensuring timely completion of each assignment.
- Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
- Improved customer satisfaction by promptly answering inquiries and providing accurate information.
- Managed incoming calls professionally, directing callers to appropriate personnel or taking detailed messages when necessary.
- Provided quality clerical support through data entry, document management, email correspondence, and overseeing operation of office equipment.
- Supported administrative staff with timely completion of daily tasks, ensuring smooth office operations.
Electronic Gaming Technician
Creek Nation Casino
04.2018 - 01.2019
- Maintained a safe work environment by strictly adhering to established safety protocols and guidelines.
- Trained new technicians on standard operating procedures, ensuring consistency across the team.
- Performed troubleshooting and diagnosis on malfunctioning equipment.
- Completed complex repairs quickly by leveraging strong diagnostic skills and attention to detail.
- Demonstrated adaptability when faced with new challenges or technologies, enabling quick mastery of necessary skills.
- Increased customer satisfaction with prompt and knowledgeable support for various technical issues.
- Optimized system performance thorough testing and analysis.
- Actively participated in continuous learning initiatives to stay updated on industry trends and advancements in technology.
- Fostered culture of continuous improvement, encouraging innovation and efficiency in technical processes.
Deli Clerk
Nichols Dollar Saver
04.2017 - 04.2018
- Greeted customers at counter to fulfill requests and answer questions.
- Precisely measured, weighed, sliced, and packaged deli products according to customer requests while minimizing waste.
- Maintained a safe working environment by adhering to food safety guidelines and promptly addressing any hazards.
- Prevented food spoilage by monitoring dates, rotating stock, and following proper storage procedures.
- Improved workflow efficiency by effectively multitasking, prioritizing tasks, and communicating with team members.
- Restocked supplies and prepared additional ingredients during downtime for expected busy periods.
Billing Assistant
COUNTRY STYLE HEALTH CARE
06.2016 - 04.2017
- Enhanced customer satisfaction by promptly addressing and resolving billing inquiries or disputes.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Improved billing accuracy by diligently reviewing and verifying invoice data before submission.
- Received, sorted, and distributed incoming mail.
- Maintained updated records of all transactions and invoices, ensuring easy access and retrieval when needed.
- Produced and mailed invoices, payment reminders, and financial notices.
- Worked closely with the accounting department to ensure timely and accurate posting of client payments.
Education
Bachelors - Healthcare Administration
Southern New Hampshire University
Hooksett, NHAssociate of Occupational Science - Healthcare Administration
Community Care College
Tulsa, OK09.2023
General educational development - Medical Billing and Coding
Community Care College
Tulsa, OK11.2021
High school or equivalent -
Hanna High School
Hanna, OK05.2016
Skills
- Strong multitasking
- Customer service
- Critical Decision-making
- ICD-10-cM coding
- Claim denial resolution
- HIPAA compliance awareness
- Medical record review
- Organizational growth
- Claims processing proficiency
- Thorough claims reviews
- Continuous learning mindset
- Medical Terminology Familiarity
- Proficiency in software
- CPT code mastery
- Healthcare billing
- Fee billing
Certification
AHIMA
Personal Information
Authorized To Work: US
Timeline
Medical Claims Adjuster
UnitedHealth Group
03.2022 - Current
Clinical Outreach Coordinator
Aston Carter
10.2021 - 01.2022
Patient Care Coordinator
Dentures and Implant Solutions
01.2020 - 09.2021
Clerk
Southeast Clinic Urgent Care
09.2019 - 02.2020
Electronic Gaming Technician
Creek Nation Casino
04.2018 - 01.2019
Deli Clerk
Nichols Dollar Saver
04.2017 - 04.2018
Billing Assistant
COUNTRY STYLE HEALTH CARE
06.2016 - 04.2017
General educational development - Medical Billing and Coding
Community Care College
High school or equivalent -
Hanna High School
Bachelors - Healthcare Administration
Southern New Hampshire University
Associate of Occupational Science - Healthcare Administration
Community Care College
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