Ashley Cross

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• Coordinated with adjusters to resolve complex claim issues promptly.
• Handled customer inquiries regarding insurance policy coverage details and payment status updates.
• Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
• Provided customer support for members to answer questions about their health plan benefits and coverage options.
• Served as a liaison between customers, insurance representatives, physicians' offices and hospitals when issues arose concerning patient care or coverage decisions.
• Researched and resolved problems regarding claim denials or discrepancies in billing statements.

• Achieved efficiency and accuracy in handling inbound calls for improved customer experience.
• Effectively multi-tasked using three computer monitors to access multiple databases.
• Kept detailed records of customer interactions, transactions, and comments for future reference.
• Resolved customer escalations swiftly to ensure satisfaction.
• Promoted to Tier 2 Customer Service Rep for outstanding performance.
• Maintained current knowledge of healthcare policies and procedures.

• Resolved escalated issues through analytical problem-solving and effective inquiry techniques.
• Assisted members with medical inquiries, averaging multiple daily interactions across various databases.
• Supervised new hires as primary support contact via Teams chat for efficient query resolution.
• Processed 15,000 files monthly for public health emergency re-determination campaign.
• Communicated essential information to individuals losing Medicaid coverage, earning recognition from C & S business managers.
• Delivered knowledgeable and friendly service, enhancing overall customer satisfaction.
• Consistently surpassed monthly performance goals, demonstrating high productivity and effectiveness.