Alexandria Nabor

Responsible for managing appeals and grievances by conducting thorough analysis, research, and resolution in accordance with regulatory and accreditation requirements. Ensures timely and accurate communication with appropriate documentation and policy references.

• Review, research, and process appeals, grievances, and complaints in compliance with federal, state, and accreditation guidelines.
• Communicate with members and providers to gather necessary information and convey case outcomes.
• Maintain expert knowledge of internal policies, procedures, benefit structures, and evolving regulatory requirements to ensure accurate and compliant case handling.
• Stay current with internal systems and external vendor tools required for case processing and documentation.

• Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
• Responded to customer calls, chats, and emails to answer questions about products and services.
• Handled complaints with prompt, courteous service to uphold professional reputation.
• Learned and maintained in-depth understanding of product and service information to offer knowledgeable and educated responses to diverse customer questions.
• Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
• Met customer call guidelines for service levels, handle time and productivity.

• Handles inbound and outbound calls with the objective of collecting delinquent accounts
• Negotiates settlements and establishes promise to pay
• Assists customers with alternatives to foreclosure on assigned delinquent mortgage loans
• Trained new employees
• Handled customer complaints with relative ease by conducting research, listening carefully, and taking appropriate action.
• Explained very technical financial information to applicants in easy to understand language.
• Complied with regulatory requirements of Bank Secrecy Act, Anti Money Laundering, OFAC, USA Patriot Act, Privacy Act, and Community Reinvestment Act.

• Interpersonal interaction with clientele
• Accepted payments/created invoices
• Scheduling of clients and personnel
• Setup and maintained filing
• Created, maintained and updated filing systems for paper and electronic documents.
• Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
• Coached new hires on company processes while managing employees to achieve maximum production.
• Organized and updated databases, records and other information resources.