Customer Service Medical Management
Resume:
Michelle Collins-Smith
Winter Springs, FL *****
********@*****.***
Insurance background. Part time caregiver. CPR current. HIV/AIDS Certificate. Continuing education. HHA certification. Have clean level 2 background.
Excellent customer service.
Work Experience
CSR/Caregiver
Caregiver, driver - Winter Springs, FL
January 2020 to Present
Caregiver/HHA Seminole County, Winter Springs, Oviedo and Longwood area. Prefer repeat clients. Allows me to become accustom to their needs and schedule. workers compensation adjuster,medical sales.
Self
January 2017 to January 2020
Working for Uber on my own schedule.
Adjuster, medical and CEU’s
SMS National
April 2011 to October 2012
Responsible for marketing services to Workers' Compensation client base. Maintain customer satisfaction. Offer and arrange CEU seminars. Quality control of vendor base. Self-employed
Self-employed
December 2009 to April 2011
in the workers compensation field to include all handling and investigations on Worker's compensation claims, medical management, bill review, filings, EDI, state laws, mediations, settlements and conclusion of the claim. Most recently worked with C.N.A to insure proper handling of claims. Kelly Services/ Free State- Optacomp- Blue Cross Blue Shield August 2009 to December 2009
Handling all aspects of workers compensation claim files to include 24 hour three point initial contacts, setting reserves, initiate benefits and complete EDI filings. Medical management, bill review, manage litigation to include settlement evaluations and file resolution, complete 30/90 day File strategy reports and attend File Review with clients.
Senior Risk Manager
Riskaware
August 2008 to March 2009
Risk Management Service, account reviews and meetings with employer representatives. Setting up and attend file reviews.
Mod reviews and presentations.
Claims Examiner III
Sedgwick CMS
October 2004 to August 2008
Handling a dedicated account to include all aspects of claims handling for FL, GA, NC. EDI filings, medical management, bill review, litigation, mediations.
Special Projects
I lead a task force in which analyze and modify the mail room process in improvement efficiency and turnaround time to get the mail to the appropriate adjusters quicker. I was charged with analyzing the Claims Clerk and Claims Assistant responsibilities, and headed the task force to create a manual on the process to set up claims, oversee the transition of responsibilities of bill payment and claims set up, training of the colleagues involved, and presenting on this changes to office management.
Claims Adjuster Handle all aspects of claim handling Broadspire /RSKCO/CNA
December 1996 to October 2004
with multi-state jurisdictions of FL, NC, GA and TN Responsible for handling of special accounts. Litigation, medical management, mediations. Worked closely with the risk managers, including quarterly meetings. Considerable litigation experience.
Claims Supervisor
PCA - Longwood, FL
1995 to 1996
Responsible for supervision of four adjusters
Reviewed claims on a monthly basis to ensure timely handling and within SHI Monitored quality control, to include, state filings, documentation, litigation, reserving, timely payments and settlement authority.
Testified at mediation, depositions, and hearings. Education, training, and license:
* Have been handling Florida claims since 1990
* Hold an All-Lines Adjusters license.
* Attend various seminars for continuing educational credits
• Member of WCCP
Education
High school diploma
Skills
• Medical Management
• EDI
• Delivery Driver Experience
• Risk Management
• Workers' Compensation
• Customer service
• Typing
• Cash handling
• Microsoft Excel
• English
• Windows
• Caregiving
• Home care
• Quality Assurance
• Hospital Experience
Certifications and Licenses
Caregivers vet/HHA
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