Amiya Mccargo

Manage 40–50 inbound calls daily in a 100% remote environment, assisting customers with insurance coverage inquiries, claims, and application processes.

Obtain and gather consumer information to accurately verify eligibility and update policy data across multiple systems.

Perform detailed data entry and documentation review, maintaining a 99% accuracy rate across claim and application submissions.

Process and escalate complex claim cases for verification, correction, and resolution within service-level agreements.

Guide customers through policy enrollment, claim submission, and payment procedures with empathy, patience, and professionalism.

Monitor claim progress and ensure timely communication between customers and insurance providers.

Utilize Salesforce, Genesys, and Microsoft Teams for case tracking, documentation, and communication across departments.

Collaborate with cross-functional remote teams to improve call handling efficiency and enhance workflow accuracy.

Ensure full HIPAA compliance and data security during all consumer interactions.

ICD-10-CM Knowledge: Apply coding awareness to support accuracy in claims processing and documentation.

Recognized for exceptional performance metrics, exceeding call goals and maintaining 95%+ quality assurance scores.Manage a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.

• Enhance customer satisfaction with timely communication,
• empathy, and clear explanations of claim outcomes.
• Develop strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes
• Settle complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.

Lead, coach, and motivate a team of 10+ employees to deliver top-tier service and meet daily operational goals.

Oversee order accuracy, shift coordination, and inventory tracking while maintaining a clean, organized, and compliant work environment.

Conduct data entry and maintain accurate documentation for payroll, team schedules, and supply records.

Train new hires on POS systems, food safety, and company policies, ensuring strong onboarding experiences and retention.

Handle conflict resolution and escalation with empathy, promoting teamwork and accountability.

Collaborate with management to analyze performance metrics and implement improvements for efficiency and morale.

Recognized for leadership, reliability, and ability to maintain operations under pressure during high-volume shifts.

Facilitated regular team meetings to communicate company updates, address concerns, and encourage open feedback.

Managed scheduling to ensure optimal coverage during peak hours while balancing employee work-life needs.

Implemented conflict resolution strategies to maintain a positive and productive work environment.

Manage opening and closing procedures to ensure store security and operational readiness as a key holder.

Oversee cash handling, including cash register reconciliation and bank deposits, maintaining accuracy and accountability.

Train and mentor staff on key holder responsibilities, company policies, and customer service standards.

Monitor inventory levels and coordinate with suppliers to ensure stock availability and minimize shrinkage.

Respond to and resolve customer complaints or emergencies during shifts, exercising sound judgement and leadership.

Maintain compliance with safety and security protocols, conducting regular audits and ensuring adherence to company guidelines.

Coordinate with management to schedule and organize employee shifts to optimize coverage and efficiency during store hours.