Seasoned Customer Service Representative with a proven track record at Everise, excelling in call center operations and customer communication. Demonstrated expertise in healthcare insurance, enhancing customer satisfaction through effective problem-solving and in-depth product knowledge. Skilled in data verification and workforce management, consistently delivering results beyond expectations.
• Conducted outbound calls to facilitate annual enrollment processes for clients.
• Provided comprehensive assistance and accurate information regarding in-network and out-of-network healthcare providers.
• Expertly explained and compared various insurance plans to help clients make informed decisions.
• Ensured clear communication of complex insurance concepts to enhance client understanding.
• Maintained up-to-date knowledge of insurance offerings and enrollment procedures.
• Delivered personalized support and tailored recommendations to address diverse customer requests.
• Efficiently managed high volumes of incoming calls with professionalism and expertise. • Provided prompt and accurate responses to customer inquiries via telephone and email.
• Demonstrated in-depth knowledge of health and prescription insurance products, delivery systems, and claims processes.
• Enhanced customer satisfaction ratings through effective issue resolution, and timely follow-up.
• Provided comprehensive support to members regarding medication management, healthcare assistance, and provider research.
• Offered guidance on the proper usage of spendable healthcare cards, and resolved related inquiries.
• Coordinated and facilitated transportation arrangements for members, as needed.
• Assisted in obtaining the necessary authorizations for prescribed medications.
• Conducted thorough searches for in-network providers, pharmacies, and other healthcare facilities to ensure optimal member care.
Customer Service & Communication:
Inbound and outbound call handling
Call Center Operations
Call adherence
Healthcare & Insurance:
Pharmacy Prior Authorization
Financial Services Support
Data Management:
Data Verification
Data Input
Report Preparation
Administrative:
Workforce Management
Office Management