Iesha Austin Anderson

• Assisted members, providers and group administrators with problems or questions regarding benefits.
• Communicated effectively via email and telephone with plan participants as well as peers to resolve issues pertaining to members' medical benefits.
• Communicated with insured individuals to explain benefits and claim information.
• Asked probing questions and offered solutions to resolve customers' issues.
• Responded to customer inquiries and problems to promote great service.
• Serviced employee insurance plans, working with group administrators, providers, patients, and other insurance carriers.
• Addressed customer inquiries to provide information and explanations on coverage and terms, expediting claims.
• Reviewed patient history to determine benefit eligibility for services.
• Aided plan participants by explaining benefits information to ensure educated selections.

• Transcribed sensitive medical data into the Vaccine Adverse Event Reporting System (VAERS) database.
• Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling participant information
• Provided excellent attention to customers concerns, while thoroughly documenting events in chronological order through telephone interactions
• Reviewed and edited transcribed reports or dictated material for spelling, grammar and proper medical terminology.
• Prioritized and organized tasks to efficiently accomplish service goals.
• Demonstrated self-reliance by meeting and exceeding workflow needs and company expectations.
• Consistently maintained a 99% accuracy rate for spelling and content and 100% Quality score on all monitored interactions.
• Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.

• Setting priorities for team to ensure task completion and KPI goals such as quality, adherence, service level and average handle times we're met.
• Evaluating performance and providing coaching and feedback as well as recognition for successes
• Supervised remote team members, team leads, & flex trainers
• Avoided attrition by closely monitoring potential issues and addressing those concerns immediately.
• Accountability for daily, weekly, and monthly activities of all team members
• Interfaced with cross-functional support groups to manage daily operations.
• Trained new employees on processes to promote productivity team-wide.
• Mentored new employees on Quality and Productivity and delivered constructive feedback to increase understanding of role expectations.
• Retained top talent by authoring and conducting team performance evaluations for corrective action planning.
• Facilitated individual coaching sessions with pharmacy services representatives to realign productivity goals.
• Top Performing Team in Quality and Attendance month over month

• Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
• Accessing reference materials to analyze and decide proper responses to telephone, electronic and inquiries such as quality, adherence, service level and average handling times we're met.
• Communicating eligibility, benefits, and claims status to members
• Documenting each customer encounter and resolution in appropriate computer tracking system and adjusts claims as necessary based upon findings.
• Meeting and maintaining production standards, counts and inquiry response turnaround times.
• De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
• Assisted customers in making payments on accounts and setting up payment plans Fielded customer complaints and queries, fast-tracking them for problem resolution.