Twana Payton-Duncan

In my current position, I work on three different campaigns Mail Order Pharmacy, Concierge Team, and Over-the-Counter (OTC)

• Contact members to provide updates on their current order status.
• Provider outreach regarding a prescription request.
• Address incoming telephone, digital, or written inquiries.
• Place over-the-counter orders.
• Verify additional medications or service needs.
• Work across Humana business units including, but not limited to Clinical Service, HCPR, Benefits, and Finance to ensure all member's needs are being met.
• Thoroughly documents, interactions in the database.
• Track requests via USPS, UPS, and Fed Ex.
• Deliver fast, friendly, and knowledgeable service for routine questions and service concerns.
• Asked probing questions to determine service needs
• Educate members on the benefits of using the mail order pharmacy.

• Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
• Learned and adapted quickly to new technology and software applications.
• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Utilized customer service software to manage interactions and track customer satisfaction.
• Developed customer service policies and procedures to meet and exceed industry service standards.
• Assisted customers in identifying issues and explained solutions to restore service and functionality.
• Resolved diverse range of technical issues across multiple systems and applications for customers and end-users across various time zones.

• Responsibilities included taking a high volume of calls and inputting the customer’s claim application
  ensuring correct case assignment.
• Handled administrative functions
• Updated database production reports, and documented and update claims files via company systems.
• Coordinated with internal and external departments as required.
• Used critical thinking to break down problems, evaluate solutions and make decisions.
• Mentored and trained new hires, as well as, consistently assisted with E-support/live chat duties as assigned.
• Applied effective time management techniques to meet tight deadlines.
• Participated in team projects, demonstrating an ability to work collaboratively and effectively.

• Analyzed medical claims and further investigate those claims where recovery potential existed.
• Initiated telephone contact and written correspondence with insurance claims adjusters and personal injury attorneys.
• Used the internet and other resources to fully investigate our clients’ insurance claims.
• Met and exceeded monthly production goals, and was responsible for processing a high volume of cases in a fast-paced production environment.
• Applied effective time management techniques to meet tight deadlines.
• Completed paperwork, recognizing discrepancies and promptly addressing them for resolution.
• Learned and adapted quickly to new technology and software applications.