Cynthia Bethea

WinstonSalem, NC ***** 336-***-**** adwg3m@r.postjobfree.com

PROFESSIONAL SUMMARY

Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Customer-focused professional with successful 16 years career in medical sector. Dynamic successful applying good communication and the ability to identify problems and execute solutions when needed Reliable employee seeking Manager position. Offering excellent communication and good judgment.

ACCOMPLISHMENTS

Resolved product issue through consumer testing.

Collaborated with team of 5 in the development of renaming a marketing program for General Motor GMAC.

SKILLS

Expense Control

Patient Care and Physical Therapy

Team Meetings

Client Rapport-Building

Claim Validity Determination

Corporate Social Responsibility

Call Center Transactions

Claims Investigation and Research

Customer Experience

Customer Expectations Management

Claims Understanding

Personnel Training

Customer Retention

Claims Analysis

Information Updates

Organization and Planning

Quality Assurance

Litigation Support

CCC Pathways

Property Adjusting

Disability Claims Process

Automobile Appraisals

Liability Management

Performance Monitoring

Claims Auditing

Team Motivation

Reserves Adjustment

Interview Claimants

Sourcing and Compiling Information

Benefits Review

Reserves Recommendations

Review Cases

Negotiation and Mediation Skills

Subrogation Expertise

Workers' Compensation Claims

Asbestos Claims

Reserve Management

Estimate Repair Costs

Manage Settlements

Insurance Fraud Expertise

Automobile Claims Specialist

Risk Assessment Software

Examine Reports

Rules of Evidence

Authorize Payments

Building Construction Knowledge

Onsite Evaluation

Verify Data

Determine Coverage

Hail and Wind Damage Assessment

Property Claims

Familiar with Fraud Statutes

Minimize Exposure

Report and Records Review

Investigate Property Damage

Damage Itemization

Procedure Implementation

Insurance Policy Review

Medicare and Medicaid Eligibility

MS Office Suite

Internal Control Systems

Effective managerial techniques

Insurance claims cases

Claims handling

High exposure claims experience

Claims reviewing

Delivery claims

Denied claims identification

WORK HISTORY

DISABILITY CLAIMS MANAGER 08/2022 to CURRENT

Lincoln Financial Charlotte, NC

Determined proper course of action for claims processing.

Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.

Handled claims consistent with client and corporate policies, procedures, best practices and regulations.

Documented and communicated timely claims information while supporting accurate outcomes.

Gathered sensitive information to update customer profiles and help with appeals process.

Conducted day-to-day administrative tasks to maintain information files and process paperwork.

Examined claims forms and other records to determine insurance coverage.

Manage up to 40 calls daily to gather information to initiate claims process.

Exceeded clients' expectations by compassionately gathering required medical and work history information to complete disability claims.

Identified issues, analyzed information and provided solutions to problems.

Used coordination and planning skills to achieve results according to schedule.

Developed team communications and information for meetings.

Maintained excellent attendance record, consistently arriving to work on time.

Exercised leadership capabilities by successfully motivating and inspiring others

Managed time efficiently in order to complete all tasks within deadlines

Skilled at working independently and collaboratively in the team environment

Worked effectively in fast-paced environments

Worked well in theteam setting, providing support and guidance

Strengthened communication skills through regular interactions with others

GUEST SERVICES REPRESENTATIVE 08/2022 to CURRENT

Clemmons Medical Center Clemmons, NC

Part-time weekend position

Greeted visitors and Patient upon arrival, offered assistance and answered questions to build rapport and retention.

Oversaw fast-paced front desk operations and visitors needs at busy facility.

Demonstrated respect, friendliness and willingness to help wherever needed.

Followed document protocols to safeguard confidentiality of patient records.

Facilitated communication between patients and various departments and staff.

Applied administrative knowledge and courtesy to explain procedures and services to patients.

Offered simple, clear explanations to help clients and families understand hospital policies and procedures.

Worked flexible hours, night, weekend, and holiday shifts.

Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.

Used critical thinking to break down problems, evaluate solutions and make decisions.

Offered friendly and efficient service to Patient and Visitors, handled challenging situations with ease.

Developed and maintained courteous and effective working relationships.

Resolved problems, improved operations and provided exceptional service.

Skilled at working independently and collaboratively in the team environment

Worked flexible hours across night, weekend and holiday shifts

Developed and maintained courteous and effective working relationships

Volunteered at local community organizations, providing assistance with day-to-day operations

Gained strong leadership skills by managing projects from start to finish

Strengthened communication skills through regular interactions with others

Exercised leadership capabilities by successfully motivating and inspiring others

Worked well in the team setting, providing support and guidance

Demonstrated strong organizational and time management skills while managing multiple projects

Self-motivated, with the strong sense of personal responsibility

Demonstrated respect, friendliness and willingness to help wherever needed

EMPLOYMENT SPECIALIST 12/2020 to 08/2022

Enrichment Center Winston-Salem

Matched clients to open positions based on skills and work requirements.

Recognized client employment barriers and devised strategies to resolve.

Maintained records of consumer employment activity such as potential and current employers.

Conducted assessments, interviews and job trials with clients to develop person-centered plans for employment and support.

Provided clients with on-the-job training and employment related support to maintain and retain employment.

Marketed individual skills, abilities and interests to develop potential employment opportunities and secure community employment.

Developed relationships with diverse businesses to develop competitive and permanent job opportunities for consumers.

Conducted outreach activities to identify, screen and enroll participants into program.

Prepared and analyzed reports pertaining to employee turnover, recruitment, compensation, employee relations and unemployment.

Pre-screened resumes prior to sending to corporate hiring managers for consideration.

Improved office efficiency by effectively managing internal communications and correspondence.

Coordinated implementation of people-related services, policies and programs through departmental staff.

Planned, monitored and appraised employee work results by training managers to coach and discipline employees.

Administered benefits programs, analyzed compensation and other competitive data and prepared budgets.

Eliminated process lags with quick processing of Work, Life skills, Building strong relationship.

PATIENT SERVICES COORDINATOR 01/2015 to 08/2022

Novant Health, Inc Winston-Salem, NC

Contacted insurance company to verify patient coverage before visit.

Demonstrated exceptional customer service to foster welcoming and professional environment for patients.

Provided patient with after-visit summary and scheduled next appointment to maintain continuous care and facilitate treatment plan.

Sent medical and surgical questionnaire forms to patients to obtain missing information.

Telephoned and interviewed patients and family members to obtain pre-registration information and confirm appointments.

Collected time of service payments and issued receipts.

Investigated, triaged and resolved patient issues to encourage positive experience during patient visit.

Oversaw monthly inventory orders to guarantee properly stocked office.

Scheduled appointments to enter appointment date and time into computerized scheduler.

Collected forms, insurance card and co-pay to facilitate registration process and prepare patient for appointment.

Called patient to confirm appointment and prepared paperwork prior to visit to expedite check-in process.

Inputted accurate patient insurance, billing and payment information in EPIC.

Respected patients by recognizing rights and maintaining confidentiality.

Verified patient availability during appointment scheduling process to reduce reschedules and cancellations.

Collected patient co-pay and issued receipt to confirm payment.

Communicated with primary care offices and insurance companies to obtain authorization.

Collaborated with colleagues to maintain and upkeep office and waiting area to provide clean and organized environment for patients.

Administered billing functions to maintain profitability and meet compliance, quality and productivity standards.

Drove proactive patient outreach activities to schedule appointments and follow-up on care and health maintenance.

Answered over 25 telephone calls per day to handle rescheduled, missed and reassigned visit requests.

Delivering the most remarkable patient experience

Monitor physicians’ schedules

Employee of the Month. Press Gainey for outstanding Patient and customer service.

Lead Patient Service Coordinator for Winston Salem and Kernersville location.

Track and monitor daily reports

Conduct daily balances

Lead training for New Hires

Preform dimensions user functions: Process referrals: Work miscellaneous work queues

Event Organizer for Winston-Salem and Kernersville location.

AUTO CLAIMS ADJUSTER 10/1988 to 06/2016

National General Insurance Winston-Salem, NC

Interviewed policyholders to verify information and obtain additional details.

Examined reports, accounts and evidence to determine integrity and accuracy of information.

Worked productively in fast-moving work environment to process large volumes of claims.

Followed up with customers on unresolved issues.

Proposed settlements for uncomplicated issues to resolve claims.

Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.

Checked level and type of coverage and evaluated contracts.

Oversaw claim recoveries, subrogation and salvage.

Processed and recorded new policies and claims.

Checked documentation for accuracy and validity on updated systems.

Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.

Verified client information by analyzing existing evidence on file.

Generated, posted and attached information to claim files.

Made contact with insurance carriers to discuss policies and individual patient benefits.

Assured timely verification of insurance benefits prior to patient procedures or appointments.

Posted payments to accounts and maintained records.

Maintained confidentiality of patient finances, records and health statuses.

Prepared insurance claim forms or related documents and reviewed for completeness.

Communicated effectively with staff members of operations, finance and clinical departments.

Calculated adjustments, premiums, and refunds.

Determined appropriateness of payers to protect organization and minimize risk.

Notified insurance agents and accounting departments of policy cancellations and changes.

Processed Tow invoices each 24 hours and mailed documentation to clients.

Assisted Call Center customer with in bound claims calls and policy needs.

Ten years’ Experience and Policy sales and service

Twenty-eight of Experience deescalating problems that may arises on a daily bases.

Sixteen years of Claim Experience (Bodily Injuries, Property Damages)

Two years of experience with Human Resources in Building Relationship Employee/Team member Relationships

Interviewed and Trained incoming Claims Adjuster and Customer service Representatives.

Lead company Community service programs and Marketing Event/ Projects

Leader to Company Advertisement both in and out state.

Supervised call Center staff on weekends and holiday five years of experience.

Assistance staffing and scheduling for peak times of high and low call volume.

Validated customer's Information: Review and paid claims

Experience Telecommuter

Lead team for paying claims for colleagues during absences: Set up claims and rental cars

Run daily claim reports in Microsoft Excel: Balancing monthly spreadsheets

Six years of Underwrote polices for the following states GA,TN,Fl,VA and SC.

Eight years of Negotiating the cost to repair of vehicles damages property

Reviewed estimates and claims of damaged property in average of thirty a day

Issued payment in the amount of $1,000 to $60,000 to referred Gold Medal shops.

Advised Customer of legal binding rights of the automobile policy and claim process

Received and made inbound and outbound calls to customers

Prepared summaries of damage, payments and policy coverage.

Answered customer questions regarding deductibles.

Verified insurance claims and determined fair amount for settlement.

Evaluated insurance policies and analyzed damages to determine coverage.

Conducted comprehensive interviews of witnesses and claimants to gather facts and information.

Evaluated evidence with ultimate goal of creating positive outcomes for client's claims.

Investigated and assessed damage to property and reviewed property damage estimates.

Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.

Investigated claims involving potential and suspected fraudulent activities.

Answered questions posed by insured and attorneys.

Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.

Reported to management on customer problems, field conditions, safety issues and policy problems.

Documented all investigation activity and presented reports to management.

Maintained contact with claimants and attorneys to determine treatment status.

Collaborated with claims department and industry anti-fraud organizations to resolve claims.

Partnered with legal counsel on litigation cases.

Reviewed field inspections and coordinated all insurance claim audits.

Followed up on potentially fraudulent claims initiated by claims representatives.

Established productive working relationships with public officials and law enforcement officers.

Directed and coordinated various investigations conducted by field investigation team.

Collected premiums on all direct collection files.

Drafted investigative reports covering phases of investigation in each case.

Compared data from surveillance footage to data on medical reports.

Synthesized data into comprehensive quarterly written reports for management.

Testified on behalf of agency as part of criminal and civic proceedings.

Eliminated claimant, premium and provider fraud.

Analyzed information gathered by investigations to report findings and recommendations.

Substantiated legitimate claims and denied unjustified claims.

Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.

Determined salvage value on total-loss vehicle.

Documented vehicle damage and submitted photographs and in-depth reports to claims department for effective processing.

Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.

Inspected vehicles involved in accidents and generated reports showing estimated repair costs.

Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.

Worked flexible hours; night, weekend, and holiday shifts.

Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.

Auto Underwriter proved successful working within tight deadlines and fast-paced atmosphere.

Maintained energy and enthusiasm in fast-paced environment.

Used critical thinking to break down problems, evaluate solutions and make decisions.

Carried out day-day-day duties accurately and efficiently.

Monitored underwriting teams performance and provided mentoring to achieve personal and department production goals.

Calculated group and individual renewal rates based on customers background, industry and demographic information.

Examined potential loss stemming from catastrophe, severity or frequency of possible loss.

Identified portfolio risks resulting from client's underlying business practices, underwriting investigations or fraud exposure.

BEHAVIOR TECHNICIAN 11/2015 to 04/2016

Maximum Healthcare Service Health And Medical Greensboro, NC

Worked as part of collaborative team to address changing needs of children and families.

Offered active guidance to families adjusting to life with loved one on autism spectrum.

Maintained professional and clinical perspective to avoid internalization regarding certain student behaviors or mannerisms.

Implemented and established behavior strategies by setting rules, reiterating expectations and rewarding good behavior for over 10 students.

Provided responsive communication by phone and email to answer general and pressing questions.

Exercised physical dexterity to safely implement crisis management interventions and therapeutic holds.

Completed one-on-one counseling with broad range of clients suffering from Autism and ADHD Behavior Health issues.

Observed and monitored client behavior and responses to treatment.

Provided comprehensive case management services, created treatment plans and connected clients and families to appropriate resources.

Consulted with other staff members regarding treatment plans as deemed appropriate by team leader.

Developed goal-oriented psychoeducational and activity therapy groups to improve clients' level of functioning.

Encouraged patients to discuss experiences in group and individual settings.

Delivered client assessments for those struggling with addiction or relationship issues and implemented strategies based on client needs.

Involved clients' family members in planning social service programs.

Worked in tandem with university leaders and health officials to foster positive student experiences and promote opportunities that enabled students to consider mental health field as career option.

Promoted positive interactions with children with ADHD, Autism and oppositional defiance behavior by using visual supports, simplifying communication, and utilizing stress scales to turn emotions into concrete concepts

Observed, monitored and recorded problem behaviors through accurate behavior-consequence data collection, graphs, and anecdotal notes

Worked as part of collaborative team to address changing needs of children and families

EDUCATION

Master of Science Human Services EXPECTED IN 12/2025

Western Governors University, Salt Lake City, UT

Bachelor of Science Psychology 01/2019

University of Phoenix, Tempe, AZ

CERTIFICATIONS

CIFA - Certified Insurance Fraud Analyst

CIFR - Certified Insurance Fraud Representative

Cardiopulmonary Resuscitation CPR

First Aid and Safety

North Carolina Public Notary

ADDITIONAL INFORMATION

VOLUNTEER/ COMMUNITY SERVICE 07/2011 to CURRENT

Grannies Love Winston Salem, NC

Prepared nutritious snacks and meals for program participants

Planned and delivered numerous activities and special events for

programs and services

Obtained and processed charitable donations to serve needs of Trinity

Glenn community

Exhibited excellent communications and customer service relations skills

Provided meals for Winston-Salem Police Department

AFFILIATIONS

Toastmasters

President of Winston-Salem Insurance Professional 1998-1999

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