FS Resume1

Felicia M. Smith

Objective: Pursuing a challenging career opportunity as a Case Worker or Benefits Coordinator with in the Health Services Administration industry. Experienced in problem solving, researching, and multitasking. Developed hands-on experience in counseling, human services, and healthcare customer service.

Professional Experience

Department of Budget and Management / Employee Benefits Division

February 2007 - Present

State of Maryland Government

Benefits Coordinator

Baltimore, Maryland 21201

• Process employee’s healthcare enrollment applications for State of Maryland employees.

• Assists employees, retirees and other agency benefit coordinators with their health care benefits questions or problems. Respond to written correspondence received from members or their representatives.

• Process child support medical verifications requested by the State of Maryland.

• Educate and assists coordinators in the health benefits enrollment process. Renew or change member’s health care benefits during open enrollment. Calculate over payments for refunds to employee and retirees.

• Participate in the State of Maryland Health Fair, preparing benefits summary statements for members.

CareFirst BlueCross BlueSheild October 2002 – February 2007

Customer Service Specialist

Owings Mills, Maryland 21117

• Provided quality support, train, and coach and counsel call center service associates to ensure the associate is capable of resolving customer service inquires.

• Coordinated with other areas within CareFirst to assist in the resolution of system issues and to verify accurate information is being disseminated.

• Facilitated timely and accurate resolution of member, institutional and provider inquires.

• Provided unpaid invoices information to our phone representatives.

• Investigated and resolved complex cases between members, providers and internal clients to ensure all deadlines met. Demonstrated ongoing high level of proficiency on benefits, policy changes, standard operational procedures, system updates and departmental performance metrics.

• Processed and registered major medical claims.

• Assisted phone representatives to help increase their quality and production average.

• Interviewed potential new hires.

• Completed special projects as assigned i.e., CASCI transition project.

CareFirst BlueCross BlueShield March 1998 – October 2002

Customer Service Representative II

Owings Mills, Maryland 21117

• Assisted management with the correspondence reduction inventory.

• Educated the provider and member community with questions concerning their benefits, enrollment, eligibility and claims resolution.

• Processed in and out of state major medical claims forms.

• Responded to customer complaints and claims appeals in a timely manner.

CareFirst BlueCross BlueShield April 1996 – March 1998

Claims Processor

Owings Mills, Maryland 21117

• Registered Major Medical Claim forms for provider and institutions.

• Verified the processing of medical claims to determine claims liability.

Education

College of Notre Dame August 2008

Bachelor Business Management

Penn Foster Career School August 2006 – August 2007

Medical Coding and Billing

United Memorial Bible College September 2003 – June 2004

Certificate of Theology

Strayer University March 2003 – July 2003

Computer Networking

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