Beatriz Cuacuas

Deliver straightforward administrative and/or other basic business services in Customer Service. Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. Issues tend to be routine in nature. Good knowledge and understanding of Customer Service and business/operating processes and procedures. Works to clearly defined procedures under close supervision.

• Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
• Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
• Maintained accurate records of customer interactions, ensuring proper documentation within the company''s database.
• Verified insurance eligibility and coverage for patients.
• Entered patient demographic and insurance data into electronic medical record system.
• Investigated insurance claims denials and appeals.
• Maintained up-to-date knowledge of product and service changes.
• Responded proactively and positively to rapid change.