
Healthcare member service professional with experience supporting members, providers, and internal teams in high call volume environments. Known for clear communication, empathy and strong follow-through when resolving complex healthcare inquiries. Skilled in benefits education, claims support,prior authorizations,and care coordination, with a consistent focus on a first call resolution and member satisfaction. Comfortable navigating multiple systems while maintaining accuracy, confidentiality, and continuity of care.
●Assist with EDI-related issues including data exchange,
claim status, and provider system access.
●Analyze data trends and identify recurring issues to
support process improvements.
●Maintain accurate provider and member records while
ensuring HIPAA compliance.
●Utilize Microsoft Excel and reporting tools to track issues,
document trends, and support operational decisions.
Provided administrative support including documentation,
correspondence, and record maintenance.
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Managed provider records and ensured accurate data entry
across multiple systems.
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Assisted with reporting and data tracking using Microsoft
Excel and internal databases.
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Maintained confidentiality of sensitive information in
compliance with organizational policies.
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Supported department operations by coordinating tasks
and meeting deadlines.