Healthcare professional with 10+ years of expertise in Medicare and Medicaid enrollment, claims processing, and X12 transaction sets. Proficient in data analysis, compliance, and process improvement. Track record of improving eligibility management and client satisfaction. Looking to apply skills in healthcare operations and customer service in a new role.
Utilized data analysis and visualization techniques to improve enrollment processes, reducing errors by 20%. I managed Medicare and Medicaid eligibility, processed retroactive updates, and resolved discrepancies in enrollment data, ensuring compliance with healthcare regulations. My contributions directly enhanced client satisfaction and streamlined operations.
Led outreach for Medicare/Medicaid inquiries and medical records, analyzing enrollment error reports to resolve discrepancies. Trained associates on compliance, performance metrics, and call quality, which enhanced team effectiveness. Managed disenrollment audits, processed disenrollment letters, and provided exceptional service through inbound/outbound inquiries, ensuring accuracy and client satisfaction.
Resolved customer inquiries regarding payments, account status, and billing issues in a high-volume inbound call center, ensuring prompt and accurate responses. By issuing refunds, credits, and processing account updates, I maintained high customer satisfaction. I consistently met performance metrics and quality standards while advising customers on business credit card services and handling policy renewals.
Managed customer service inquiries in a high-volume inbound call center, addressing issues like payments, account status, and billing. I processed refunds, credits, and account updates, resulting in high customer satisfaction. Met productivity targets, adhered to quality metrics, and provided expert advice on business credit cards and policy renewals.