Clifton Horton

Facilitating the Resolution of Provider-Related Issues:

• Proactively address and resolve provider-related issues by utilizing various state systems, including communication, enrollment, and support services. Ensure seamless interactions between providers and the organization to maintain service quality and provider satisfaction.

Collaboration with Internal and External Stakeholders:

• Collaborate closely with internal teams (e.g., customer support, operations, and IT) as well as external partners (e.g., insurance companies, healthcare providers) to resolve provider inquiries, concerns, and complaints promptly. Facilitate smooth information exchange and ensure timely, effective resolutions to issues.

Education on Policy Standards:

• Educate healthcare providers on enrollment and credentialing policies and procedures. Offer clear guidance on compliance requirements and help providers understand the standards necessary for successful enrollment and continued participation in programs. Provide ongoing support and resources to ensure providers' adherence to these policies.

Managing Customer Service Inquiries:

• Efficiently handled customer service inquiries, ensuring each interaction was thoroughly documented in the CRM system for accurate tracking and seamless issue resolution. Worked to promptly address customer concerns, ensuring timely follow-up and satisfaction.

Enhancing Customer Satisfaction:

• Contributed to improved customer satisfaction by maintaining and enforcing quality control policies that aligned with established performance benchmarks. Actively monitored service quality, ensuring that customer interactions met the organization's high standards for professionalism and responsiveness.

Resolving Customer Escalations:

• Addressed customer escalations directly by engaging with clients to understand concerns and ensure appropriate resolution. Demonstrated effective problem-solving skills to de-escalate issues, leading to higher customer retention and satisfaction.

Preparing Financial Estimates and Ensuring Insurance Verification:

• Accurately prepared financial estimates for medical procedures, ensuring clear communication of expected costs. Collaborated with patients and insurance providers to verify coverage, facilitate payment collection, and confirm accurate billing practices.

Fostering Client Relationships:

• Cultivated strong, positive client relationships to enhance overall customer satisfaction. Actively engaged with clients to understand their needs and preferences, using these insights to identify cross-selling opportunities that aligned with their goals and enhanced their overall experience.

Assisting with Client Onboarding:

• Played a key role in the client onboarding process, guiding new clients through initial steps and ensuring a smooth transition. This hands-on support contributed to improved client retention rates by setting clear expectations and building trust from the outset.

Enrolling Clients in ACA Health Insurance Plans:

• Assisted prospective clients in selecting the most suitable ACA health insurance plans based on their unique healthcare needs. Provided in-depth explanations of plan features, benefits, and coverage options to ensure clients fully understood their choices and made informed decisions.

Delivering Multi-Channel Customer Support:

• Provided comprehensive multi-channel customer support, ensuring timely and effective resolution of client inquiries across various platforms (e.g., phone, email, chat). Prioritized customer needs and streamlined processes to enhance response times and overall client satisfaction.

Developing Training and Educational Materials:

• Developed and designed clear, user-friendly training and educational materials aimed at streamlining the client onboarding experience. Focused on simplifying complex information, which facilitated a smoother onboarding process and improved customer understanding of product features and services.

Designing and Conducting Customer Seminars:

• Conceptualized and led customer seminars to educate clients about product offerings and best practices, resulting in a 10% increase in product and service adoption among existing clientele. These seminars helped clients maximize the value of their purchases while strengthening customer loyalty.

Analyzing Sales Data for Process Improvements:

• Analyzed sales and customer data to identify trends, cost-saving opportunities, and process inefficiencies. Based on these insights, recommended targeted measures to clients that optimized their use of products and services, leading to enhanced operational efficiency and improved bottom-line performance.

Developing Strategic Business Plans:

• Developed and implemented strategic business plans that successfully led to the acquisition of new client prospects. Identified key market opportunities and tailored approaches to target potential clients, resulting in expanded business growth and increased market presence.

Maintaining and Nurturing Client and Vendor Relationships:

• Maintained and nurtured long-term, mutually beneficial relationships with clients and vendors through consistent communication, collaboration, and trust-building efforts. Ensured ongoing satisfaction and engagement, positioning the organization as a reliable and valued partner.

Leveraging Communication and Negotiation Skills:

• Utilized strong communication and negotiation skills to secure new business opportunities from key clients. Effectively identified client needs, presented compelling solutions, and negotiated favorable terms, driving both revenue growth and client retention.