Tracey M Smith

Claims Supervisor @Aetna, A Cvs Health Company

Jacksonville, FL, US

Supervisor Claims JCA Provides direction, instruction, and guidance to examiners for the purpose of achieving TAT and Quality goals. Able to identify examiner’s strengths and weaknesses. Develop and implement strategies used to reach team goals. Provide training via communicating clear instructions. Manage the flow of day-to-day operations. Distribute reports to the appropriate individuals. Serve as a mentor and motivator. Able to make sound decisions and work with all supervisors and staff at all levels of responsibility. As a superb communicator able to think, communicate and present information effectively to people of all social backgrounds. • Identify all issues in team and provide continuous support to all members according to operating standards• Builds a cohesive team through collaboration, inclusion, and diverse thinking• Responsible for ensuring satisfaction through prompt, accurate and careful claim handling• Develop, train, evaluate and coach team to provide cost effective claim review/processing and claim service while ensuring compliance and quality standards are met.• Oversee effective working of production personnel and prepare effective production schedules and ensure compliance to all company policies• Act as liaison between team and other areas communicating workflows, results, ideas, and solutions.• Utilize available incentive programs to reward, recognize, and celebrate team and individual success• Responsible for fostering discussions surrounding problem identification and escalation for resolution • Vast knowledge of Institutional and Professional claims processing and pricing• Knowledge of HMO, PPO, Medicaid, Medicare, JCA and Traditional claims processing• ASQ CQIA: American Society for Quality, Certified Quality Improvement Associate• Vast knowledge of AMA, ASA, and CMS guidelines

Florida State College at Jacksonville

Supervision & Management/Sociology