Brooke Riley

• Managed benefits for Tricare East plans, serving Active Duty, Retired, and National Guard personnel and their families.

Assisted beneficiaries in understanding insurance benefits, copayments, deductibles, and out-of-pocket costs.

Adjusted and reprocessed claims for beneficiaries and providers across all insurance plans.

Facilitated patient referrals for specialist visits through primary care physicians.

• Processed prior authorization requests for medications, services, or treatments from specialists.
• Mentored customer care associates by providing guidance during call reviews and research processes.
• Supported new hires in acclimating to remote work while managing calls effectively.
• Collaborated via Microsoft Teams to enhance team performance and resolve inquiries promptly.
• facilitating sign-in process and troubleshooting technical difficulties for beneficiaries and providers calling customer service

• Managed inbound calls to refill prescriptions and provide medication pricing information.
• Assisted patients with understanding out-of-pocket costs and pharmacy benefits.
• Facilitated prior authorization processes, ensuring valid prescriptions from ordering providers.
• Employed STAR method in customer service, delivering prompt and courteous interactions.
• Utilized active listening techniques to address patient inquiries effectively.
• Set clear expectations while maintaining a positive and professional demeanor.
• Provided technical support for website navigation and account access issues.

• Maintained and operated boiler systems on steam-powered vessels to ensure efficient propulsion.
• Trained sailors in machinery operation to enhance crew competency and safety.
• Conducted fire-fighting procedures to protect ship integrity and crew safety.
• Traveled internationally for specialized training to improve technical skills.
• Monitored boiler operations during watch to uphold system reliability.
• Documented detailed logs to maintain accurate records of operations and incidents.