Carla Smith
@carlasmith1
Detail-oriented healthcare customer service professional with claims expertise.
What I'm looking for
I am a detail-oriented healthcare customer service professional with over six years of contact center and healthcare support experience, focused on resolving provider, member, and claims inquiries while maintaining HIPAA compliance.
I have a proven track record managing complex insurance verification, prior authorization requests, reimbursement and billing support, and documentation across multi-system environments, including Salesforce and other healthcare claims systems.
I collaborate effectively with providers, payers, and internal teams to research discrepancies, drive accurate claim outcomes, and maintain high standards of data integrity and professionalism in remote contact center roles.
Experience
Work history, roles, and key accomplishments
Customer Service Advocate
Fidelis Care
Oct 2021 - Dec 2025 (4 years 2 months)
Resolved complex provider and member inquiries on coverage, claims, and billing, verified eligibility and benefits, and ensured accurate documentation and HIPAA-compliant processes to improve claim outcomes.
Patient Care Coordinator
Acaria Health Specialty Pharmacy
Apr 2019 - Sep 2021 (2 years 5 months)
Managed 50+ daily patient and provider interactions resolving prescription, insurance, and documentation issues while maintaining accurate records and ensuring compliance with payer policies and regulations.
Education
Degrees, certifications, and relevant coursework
Barry University
Bachelor of Science, Business Management
Completed a Bachelor of Science in Business Management focused on management principles and business operations.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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