CaSonia Yarborough

· Guided callers through enrollment processes for Calibrate programs, ensuring a smooth onboarding experience. with enrolling in Calibrate programs

· Identify and triage high profile callers and complex situations to the appropriate client support team.

· Review and verify member insurance information for accuracy and completeness.

· Coordinated with pharmacies regarding prescription needs, cancellations, and updates to maintain accurate member records.

Reviewed and assigned faxes to member profiles, facilitating timely follow-up tasks.

· Review and respond to voicemails, taking direct action when possible or routing to the appropriate team.

• Resolved technical issues for customers, enhancing user satisfaction through effective troubleshooting tools and software.
• Provided technical assistance to customers via phone, email and online chat.
• Diagnosed and fixed network connectivity problems by resetting modems and routers. by resetting modems and routers.
• Used remote login tools to assist clients with technical and product questions.
• Communicated effectively with customers to ensure clarity and understanding of solutions, improving overall customer experience.
• Maintained up-to-date knowledge of product features and industry trends for effective support.
• Documented customer interactions and technical solutions in support ticketing system, contributing to knowledge base for future reference.

• Evaluated claims for property damage due to natural disasters.
• Assessed and investigated property and auto claims, determining liability and coverage.
• Collected evidence, negotiated settlements, and facilitated equitable resolutions.
• Presented findings to clients and internal teams to streamline claims processing.
• Oversaw caseload while complying with company guidelines and meeting deadlines.
• Maintained accurate records of claims and documentation in the company system.

Collaborated with clients to gather necessary documentation and information

• Determined liability, compensability and benefits due on each claim.
• Investigated claims, applied coverage, and documented findings to ensure accurate claim resolutions.
• Resolved client inquiries regarding claim status and provided timely updates on progress.
• Maintained comprehensive records of claim processing activities to uphold compliance with company policies and procedures.
• Gathered necessary documentation from clients to facilitate efficient claims processing.

• Assisted members in understanding insurance benefits and securing necessary authorizations for optimal care.
• Supported patients through the nurse’s advice line, ensuring accurate information delivery.
• Managed patient intake and follow-up communication effectively.
• Maintained accurate patient records using electronic health systems.
• Maintained accurate client records in accordance with agency policies and procedures.
• Responded promptly to patient inquiries about care plans, enhancing patient satisfaction and clarity.
• Provided crisis intervention services during emergencies.
• Conducted initial assessments and evaluations to identify patients' needs, facilitating tailored care plans.

• Managed document processing to ensure compliance with regulatory standards, minimizing risks associated with non-compliance.
• Reviewed documents for accuracy and completeness, ensuring adherence to applicable regulations and enhancing overall quality.
• Resolved discrepancies between physical files and electronic records, ensuring data integrity within the system.
• Facilitated efficient document flow by utilizing strong organizational and planning skills to manage multiple tasks simultaneously.
• Implemented best practices for ensuring secure access to confidential information stored in the system.
• Completed documents and work requests according to company standards.
• Completed transmittal logs by accurately filling out necessary information and storing them in designated files.
• Maintained records of all documents scanned and indexed into the document management system.
• Systematically organized physical files by following established filing protocols to enhance accessibility and retrieval.

• Managed operational workflows to streamline processes and improve efficiency.
• Implemented process improvements to reduce redundancies and optimize performance.
• Monitored compliance with regulatory standards and internal guidelines to ensure adherence.
• Created and validated documents under strict compliance protocols.
• Demonstrated proficiency using various banking and loan servicing systems.
• Addressed customer and banker inquiries, resolving complex issues effectively.
• Developed reports tracking key performance indicators for management insights.
• Provided training and guidance to staff on operational procedures, policies and regulations.