Andrea Mack

· Provides guidance and support to members, ensuring they understand their benefits and how to access their extra benefits.

· Provides education to members to support them in managing their health and benefits.

· Guides members to the appropriate health resources. Offers alternatives where appropriate

· Assists with OTC benefits.

· Maintained high standards of customer service by building relationships with clients.

· Analyzed customers' financial situations to recommend appropriate life insurance policies.

· Cultivated customer relationships to provide customized life insurance solutions.

· Attended continuing education courses and workshops to gain additional insurance industry knowledge.

· Maintained knowledge of benefits claim processing, claims principles, medical terminology, procedures, and HIPAA regulations.

· Submitted electronic/paper claims documentation for timely filing.

· Managed a large volume of medical claims daily.

· Verified patient insurance coverage and benefits for medical claims.

· Researched and resolved complex medical claims issues to support timely processing.

· Handled customer inquiries and suggestions courteously and professionally.

· Actively listened to customers, handled concerns quickly, and escalated major issues to our supervisor.

· Answered the constant flow of customer calls with minimal wait times.

· Answered customer telephone calls promptly to avoid on-hold wait times.

· Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.

• Bathing and Dressing: Assisted with personal hygiene, including showering.

• Grooming: Assisted with brushing hair, shaving, and applying makeup.

• Toileting: Assisted residents with using the restroom.

• Mobility Assistance: Assisted residents with moving around safely, including transferring from bed to chair, and using a wheelchair or walker.

• Monitoring: Observed and reported changes in the individual’s physical or mental health.