Your Name

Handle 80+ calls daily regarding Medicaid and behavioral health benefits, achieving a 93% first-call resolution rate.

Process 2,000+ prior authorization and referral requests with 98% accuracy.

Assist members with therapy and substance use program scheduling, resulting in a 20% increase in engagement.

Reduce call handling time by 15% using quick-reference tools and active listening.

Maintain 99% HIPAA compliance by verifying PHI/PII for all patient interactions.

Escalate and resolve high-risk cases, helping achieve a 95% SLA compliance rate.

Document 100% of cases in Salesforce CRM and Facets with real-time accuracy.

Recognize for a CSAT score of 4.9/5 from behavioral health member feedback.

Answered 100+ member calls/day related to behavioral health coverage and authorizations.

Provided high-volume chat and email support to patients and members, handling 60+ inquiries daily with accuracy and empathy.

Simultaneously handled 4–6 live chat sessions, assisting with healthcare benefits, eligibility, claims status, and appointment coordination.

Resolved eligibility and benefit inquiries with a 96% satisfaction rating.

Processed 1,800+ claims adjustments over 12 months, reducing backlog by 25%.

Documented all interactions in QNXT and Avaya, maintaining 100% data accuracy.

Educated members on available behavioral health services, leading to 15% utilization growth.

Recognized for reducing escalations by 22% via excellent rapport-building.

Supported members via chat/email platforms, managing up to 50 daily inquiries.

Contributed to cross-training team initiative, boosting team call handling by 20%.