JASMINE WRIGHT

• Processed prior authorization requests for medications, diagnostic procedures, and treatments, ensuring compliance with payer requirements.

• Reviewed medical records and provider documentation to support authorization requests.

• Communicated with insurance companies to resolve denied or delayed authorizations.

• Worked closely with healthcare providers to facilitate timely approvals and minimize treatment disruptions.

• Maintained accurate records of approvals, denials, and appeals in EHR systems

• Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
• Maintains performance and quality standards based on established contact center metrics
• Provides customer service in a high pace contact environment over the phone, via live chats and emails
• Serves as the front-line resolution advocate on various member and/ or provider inquiries, requests, or concerns

• Handle 50+ calls daily, maintaining a 99% customer satisfaction rate in a high-paced environment
• Guide customers through company systems, forms, and services, ensuring clarity and efficient service delivery
• Document case details accurately using company software to manage assigned cases effectively
• Resolve issues by actively listening and empathizing with customers' needs, providing quick and effective solutions