Bianca Ford

• Receive and resolve up to 70 calls per day regarding patient inquiries, by enhancing satisfaction and access to care.
• Collaborate with healthcare providers to clarify benefit verification ,ensuring efficient call resolution.
• Review and triage prior authorization requests for timely clinical resolution.
• Explain medical bills, deductibles, coinsurance, and copay's, enhancing prescription fulfillment efficiency and care quality standards in a call center environment.

• Analyzed customer account discrepancies and addressed billing errors and fraud claims, ensuring adherence to Regulation E and Regulation Z.

• Managed caseload documentation and oversaw the resolution of disputes by enforcing Mastercard/Visa regulations, along with the timely issuance of provisional credits, fees, and interest.

• Facilitated professional communication between customers and the customer service department through both phone and written correspondence.

• Addressed and resolved client inquiries by leveraging an in-depth knowledge of products, services, and company policies via phone, email, and live chat.

• Managed complex issue resolution for corporate and government clients, demonstrating expertise in multi-platform computer systems.

• Investigated and proposed solutions for fraud and disputes, balancing customer satisfaction with loss mitigation in a high-volume call center environment.

• Upheld legal and regulatory standards, consistently applying ethical decision-making and reporting control issues.

• Resolved escalated customer account issues, enhancing claim accuracy and compliance. Examined and enter basic claims for appropriateness of care and completeness of information in accordance with the accepted coverage guidelines, ensuring that all mandated government and state regulations are consistently met.
• Facilitated cross-team collaboration, reducing inquiry resolution time.
• Completed Salesforce Sales Operation Course to enhance skills.
• Verified insurance coverage to enhance prescription service efficiency, boosting patient satisfaction.
• Processed medical claims, benefit verification, and prior authorizations ensuring accuracy and timely payments for healthcare providers and pharmacies.
• Contributed to a fast-paced call center environment with a focus on quality and detail.

• Balanced daily cash deposits and vault inventory with zero error rate.
• Identified and resolved complex client service issues to deliver exceptional customer service.
• Process teller transactions, open new accounts and balance a cash drawer timely and accurately
• Responsible for marketing and selling bank products and services to potential customers.