Alexia Galloway

• Assessed and resolved inbound calls from providers and patients, providing detailed information on status updates and criteria for denied requests.
• Coordinated comprehensive prior authorization submissions to insurance providers and third-party payers, encompassing imaging, surgical services, specialty visits, and DME.
• Utilized payer portals and phone interactions with insurance companies to validate and confirm patients' eligibility and coverage details.
• Engaged with physicians and healthcare facilities to ensure timely acquisition of clinical documentation required for authorization compliance.

• Responded to 75–120 inbound calls daily, providing comprehensive information on Medicare benefits and plan coverage to beneficiaries, caregivers, and providers.
• Provided comprehensive education to callers regarding Medicare Advantage (Part C), Prescription Drug Plans (Part D), Medigap (Supplemental Plans), and Original Medicare (Parts A & B) to enhance understanding of available options.
• Directed beneficiaries through comprehensive enrollment processes to ensure understanding of eligibility criteria. Managed special enrollment periods and communicated plan changes effectively.
• Oversaw resolution of complex concerns including coverage denials, premium billing challenges, ID card issuance, pharmacy network accessibility, and provider engagement. Delivered effective solutions to enhance customer satisfaction.

Executed daily invoicing processes by creating and sending approximately 320 invoices to maintain cash flow.

Reviewed and confirmed shipping documents alongside agreed-upon rates to maintain operational integrity.

Monitored project timelines to guarantee timely delivery of all tasks and deliverables.

Oversaw customer payment processing and transaction recording to ensure accuracy and compliance. Managed financial documentation to streamline operations and improve efficiency. Led initiatives to address payment issues, fostering positive customer relationships.

Identified and reconciled discrepancies to uphold integrity of financial documentation.

Maintained accurate and organized billing records to ensure efficient financial operations.

Implemented procedures to uphold organizational integrity and adherence to company regulations.

Formulated comprehensive policies to guide decision-making and maintain organizational standards.

Engaged with customers and collaborated with dispatchers and sales personnel to enhance service delivery.

Led initiatives to address billing issues by coordinating with accounting and other departments. Fostered collaboration among teams to streamline resolution processes. Championed effective communication strategies to improve overall billing accuracy.

Managed invoicing operations to uphold billing integrity and client trust.

Analyzed billing discrepancies to ensure accurate financial records and maintain customer trust.

Investigated discrepancies in charges and payments to maintain strong financial integrity.

Led initiatives to strengthen customer relationships, fostering loyalty and retention. Oversaw operational strategies to optimize efficiency and drive performance improvements. Coordinated with cross-functional teams to implement best practices and enhance service delivery.

Produced detailed billing reports to facilitate informed decision-making for management.

Coordinated interdepartmental efforts to optimize operational efficiency and financial outcomes.

Facilitated informed decision-making to support project objectives and team alignment.

Utilized transportation management systems (TMS) and billing processes to enhance operational efficiency.

Leveraged software expertise to enhance efficiency in billing processes.

Managed freight billing operations to maintain compliance with industry standards.

Utilized understanding of logistics and accounting principles to enhance financial accuracy.

Monitored compliance with safety and regulatory standards to mitigate risks and enhance operational integrity.

• Provided comprehensive support by resolving 60–100 member calls each day concerning orders, accounts, membership, billing, refunds, and store or online services.
• Achieved timely updates on order statuses to enhance customer experience. Resolved shipping delays through proactive investigation and communication. Enabled smooth cancellations and returns or exchanges, contributing to customer retention.
• Achieved high customer satisfaction by effectively resolving membership renewals, upgrades, and cancellations. Streamlined billing processes and addressed payment concerns, resulting in improved operational efficiency.
• Resolved login issues and account access problems, enhancing user experience. Improved website navigation and app troubleshooting processes, contributing to overall customer satisfaction. Met and exceeded performance metrics, including average handle time (AHT).