Kalita Sistrunk
Columbia
Summary
Experienced and skilled professional in premium and billing seeking advancement within a growth-oriented company. Possessing a strong aptitude for learning, I am eager to explore opportunities within this exceptional organization. My passion for the insurance industry drives me to continuously expand my knowledge and skills, aiming to become an invaluable asset to the company's success.
Overview
17
17
years of professional experience
Work History
Sr. Business Ops Coordinator
Aflac
09.2021 - Current
- Collaborate with the billing team, premium application team, suspense team, and internal partners to resolve any premium, billing and invoice issues.
- Review, research, update and make necessary billing changes to rectify errors or escalated request.
- Serve as the primary point of contact for escalated billing and invoicing issues, deftly navigating challenging situations to achieve satisfactory resolutions while preserving client trust and satisfaction
- Continuously refine processes for monitoring account health, enabling early identification of at-risk clients and targeted intervention strategies to prevent attrition
- Coordinate trainings to educate teams on how to research and identify errors or concerns.
- Work closely with stakeholders and IT partners on complex billing items, validation and System enhancements.
- Support our internal partners such as Enrollment, Group Set Up and Client Relations for billing and invoicing inquiries and/or concerns.
- Support Premium application team with payment concerns or complex issues.
- Maintain positive relationships with internal and external clients.
- Engaged in migrations of groups for billing and invoicing needs.
- Support Prem app and suspense teams to resolve billing and remittance challenges, and provide direction with payment histories as needed.
- Support Port team with complex issues for direct billing, ACH drafts and billing discrepancies.
- Assist with day to day challenges, concerns, changes, and process improvements for our Premium and Billing department.
Client Service Lead Specialist
Aflac
01.2021 - 09.2021
- Performed various processes and functions on the Wynsure system for the Client Services Premium team.
- Served as the (SME) subject matter expert for Wynsure billing and premium functions
- Gathered reports daily of the team's performance and numbers to help determine their goals.
- Led daily huddles while motivating the team. Assist the team with request, concerns, and issues.
- Provided instructions for daily task and resolving request. Assist Aflac’s internal clients with understanding Wynsure processes and functions to help smooth the relationship of our customers.
- Review and research premium and billing information to resolve escalations.
- ·Reserved facilities and coordinated trainings to enhance the knowledge of my team and internal clients with the premium and billing aspect of the Wynsure system.
- Provide visual aid and step by step instructions to perform functions or processes
- ·Instructed one on one informal trainings with my peers to educate them with the Wynsure billing processes and provide feedback with concerns.
- Use sound judgement and make decisions to help smooth the processes and system issues
- Assisted Doc Control with developing and revising Wynsure premium processes
- Served as an instructor for a variety of assigned topics when my supervisor is out of the office
- Assisted Wynsure Business Consultants and Contractors with System validation and documentation
- Group lectures advising the beginning to end of Wynsure processes and how the system functions
Senior Client Service Specialist
Aflac Group
10.2018 - 01.2021
- Handle escalated premium issues; identify issues
- Perform various premium processing functions and gather the daily reports
- Assist with special projects; Lead training classes for the team
- Provide the instructions to the team and assign task per supervisor request
- Provided billing assistance and communicate with other departments to resolve issues and concerns related to the Wynsure system
- Handled complex request, billing discrepancies, guidance and support for premium application and billing
- Assisted the team with complex task and solving problems/answer questions
- Managed collections, process payments, cancel accounts, process ports, research suspense and various premium functions
- Provided knowledge of Wynsure operational practices and procedures to my peers and other departments
- Assisted Wynsure business consultants and contractors with system validations and documentation
- Collaborated with cross-functional teams to deliver exceptional client support, resulting in increased customer retention and satisfaction levels.
- Improved client satisfaction by promptly addressing inquiries and resolving issues, ensuring a seamless customer experience.
Accounting Specialist II/GAS Participate User Acceptance Training (UAT) Participate
Aflac Group
11.2017 - 09.2018
- Integration subject matter expert for insurance premium and billing
- Identifying payment discrepancies in Pega Workflow
- Verify Aflac Group Business Objectives can be met using new systems
- Provide guidance and support for premium application and billing
- Test system with various billing scenarios
- Subject Matter Expert in Objective Management and identifying defects
- Define business processes
- Assist business consultants and contactors with system reviews and documentation
Accounting Specialist II
Aflac Group
01.2015 - 11.2017
- Collect payments and reconcile group account premium
- Perform certificate maintenance with the reconciliation process by properly clearing suspense on group accounts
- Process refunds for and apply suspense for various groups, along with generating a Paid to Date Calculator’s and pay histories
- Ensure accurate adjustments and calculations and ensuring premiums are posted correctly
- Navigate computerized systems for information gathering and research
- Identify account discrepancies and take action to resolve or refer to the appropriate team member or department for a resolution
- Ensure premium, approvals and correspondences are accurate
- Review and enter data for accuracy of premium
- Compile researched information for reports
- Communicate internally via written correspondence and phone calls
- Proper use of Aflac manuals such as SOP’s and training manuals for fact gathering
- Navigate internal database systems such as CRM, Case 360Workflow, SharePoint and Excel spreadsheets according to the customer’s account needs and resolution
- Assist team members with research, payment discrepancies and refunds when needed
Customer Service Specialist II
Aflac Group
05.2014 - 12.2014
- Educated customers of their benefits and certificates
- Advised insureds of Porting/Direct Bill process and entered port request information
- Provided status of claims and/or information required for claims to process
- Prepared supporting documentation for escalations
- Assisted with resolving the customer’s issues to prevent the same issues from reoccurring in the future
- Notated customer accounts, ensured customer satisfaction
Customer Service Specialist
Blue Cross Blue Shield
10.2010 - 05.2014
- Assist health care providers with medical benefits and eligibility, claims, appeals
- Respond to unresolved calls by verbal and/or written correspondence
- Updates the database with information related to the escalations including the root causes, findings and the resolution
- Prepared supporting documentation and summarized for escalated issues
- Communicated with various departments for research and resolution
- Document patient’s accounts and resolve provider’s issues within company policy
- Audit member’s accounts for accurate claims payments and processing
- Kept the providers updates with the progress of the escalations
- Submitted and received correspondence from in state and out of state providers
- Submitted appeal’s on behalf on provider’s for filed claims
- Provided excellent and efficient Customer Service
Store Manager
Fast Cash Payday Advance
04.2008 - 07.2010
- Responsible for monthly Audit on customer loan accounts
- Audit cash tills daily
- Managed cash, checks and express money payments, bank deposits
- Reviewed financial statements and worked collections
- Completed daily reports while utilizing spreadsheets, managed customer files
- Provided excellent face to face and phone customer service
Education
No Degree - Business Management
Claflin University
Orangeburg, SCHigh School -
Orangeburg Wilkinson High School
05.2001
Skills
- Manage collections and billing discrepancies
- Decision-making
- Manage and Process Refunds
- Determine disposition of funds
- Manage group and member invoices
- Certificate Maintenance
- Identify discrepancies and Pay Histories
- Service accounts
- Sound judgement
- Efficient with gathering and obtaining information
Timeline
Sr. Business Ops Coordinator
Aflac
09.2021 - Current
Client Service Lead Specialist
Aflac
01.2021 - 09.2021
Senior Client Service Specialist
Aflac Group
10.2018 - 01.2021
Accounting Specialist II/GAS Participate User Acceptance Training (UAT) Participate
Aflac Group
11.2017 - 09.2018
Accounting Specialist II
Aflac Group
01.2015 - 11.2017
Customer Service Specialist II
Aflac Group
05.2014 - 12.2014
Customer Service Specialist
Blue Cross Blue Shield
10.2010 - 05.2014
Store Manager
Fast Cash Payday Advance
04.2008 - 07.2010
No Degree - Business Management
Claflin University
High School -
Orangeburg Wilkinson High School
Similar Profiles
Kenteryca IvyKenteryca Ivy
Insurance Agent at AflacInsurance Agent at Aflac
Taylor StuckeyTaylor Stuckey
Benefits Associate at AFLACBenefits Associate at AFLAC
Joshua BarzJoshua Barz
Insurance Agent at AFLACInsurance Agent at AFLAC