CAROLINE SIAKI
San Mateo,USA
Summary
Compassionate healthcare customer service professional with 5+ years of experience supporting members, healthcare providers, and patients in fast-paced healthcare environments. Experienced in insurance verification, benefits and eligibility, claims resolution, HIPAA compliance, and delivering exceptional patient-centered service. Recognized for professionalism, empathy, attention to detail, and building trust through outstanding support.
Overview
5
5
years of professional experience
Work History
Customer Care Representative II
Elevance Health
08.2021 - Current
- Managed 100+ inbound calls daily, assisting members and healthcare providers with benefits, eligibility, claims, and billing inquiries to ensure timely support.
- Verify insurance coverage, eligibility, and benefits while maintaining accurate documentation.
- Researched and resolved claims, reimbursement, and benefit issues, enhancing member satisfaction and service efficiency.
- Explain EOB/EOP information clearly to improve member understanding.
- Maintain strict HIPAA compliance while protecting confidential information.
- Collaborate across departments to resolve complex member and provider concerns.
- Consistently exceed quality and productivity standards while delivering compassionate service.
- Recognized as a high performer for customer service, quality, and productivity.
- Successfully managed a high-volume workload while maintaining accuracy and professionalism.
- Built positive relationships with members, providers, and cross-functional teams.
Education
High School Diploma -
Pittsburg High School
Skills
- Patient Relations
- Customer Service Excellence
- Insurance Verification
- Benefits & Eligibility
- Patient Scheduling
- Claims Resolution
- Registration Support
- HIPAA Compliance
- EMR/EHR Systems
- Medical Terminology
- Conflict Resolution
- Team Collaboration
- Problem Solving
- Time Management
- Attention to Detail
- Confidentiality
- Facets
- Genesys Cloud
- Citrix
- Compass
- Microsoft Office
- Outlook
- Microsoft Teams
- Unified desktop
Key achievements
- Recognized as a high performer for customer service, quality, and productivity.• Successfully managed a high-volume workload while maintaining accuracy and professionalism.• Built positive relationships with members, providers, and cross-functional teams.
Timeline
Customer Care Representative II
Elevance Health
08.2021 - Current
High School Diploma -
Pittsburg High School