Angelinetta Watson

• Assisted customers with inquiries, ensuring timely and accurate resolution of issues.
• Processed customer requests using CRM systems, maintaining up-to-date records for efficient follow-up.
• Coordinated communications between departments to enhance service delivery and customer satisfaction.
• Mentored junior representatives on best practices in customer interaction, elevating overall team performance.
• Managed a high volume of inbound calls daily, maintaining composure under pressure while providing top-notch service to clients.
• Provided exceptional service by proactively addressing customers'' needs and concerns. Assisted with Arsos and Web Chat Bailout Projects Facilitated Classes for new Member Solutions Advocates

Responsible for assisting Customers with Standard and, pharmacy claims, locating in network providers Subject Matter Expert.

• Subject Matter Expert (SME), Notification Unit (NU) Department Experienced trainer regards case notification; procedural guidelines, and compliance regulation.
• Assist in disciplines and continuing education on specialty plans.
• Served as liaison for several departments (Client and Provider Services, Notification Unit, Provider Response Unit, Intake departments.
• As well as for upper management.
• Maintained correspondence with members, providers and facilities in case decisions per health plan terms
• Connected with team members and department leads updating case processes maximizing time management Facilitator of fellow co-workers on specialty plans.
• Improved operations by working with team members and customers to find workable solutions.
• Earned reputation for good attendance and hard work.
• Recognized by management for providing exceptional customer service.
• Handled all delegated tasks, including Training and conflict resolution.tra

• Liaison between intake agents and department for trouble-shooting cases and/or appeals per health plan guidelines Point of contact for scheduling conferences between internal medical directors and external physicians for appeals Coordinated with staff to work more efficiently during heavy workload occurrences.
• Utilized Outlook. MS Word and Excel to compile data gathered from various sources.

• Provider Response Unit (PRU) Department Specialized in SME duties focused on meeting deadlines per health plan obligations Served as a troubleshooter on escalated case issues and customer service difficulties
• Coached team members for appeals processes, and escalated calls.

• Case creation for radiology, sleep and cardiology studies in outpatient settings Assisted with providers' offices and members for case processing in connection to nursing or PRU departments Data entry and verification of patient, physician and facility information in compliance with HIPAA regulations Trained new hire employees by arranging side-by-sides and Q&A sessions during the nesting period on call floor.
• Maximized office efficiency by answering more than 50 incoming calls per day to provide office information and transfer calls to desired personal.
• Coordinated office activities and operations to secure efficiency and compliance with company policies.