Krystal Calvert

● Manage contact with patients, physicians, and medical staff regarding patient care and registration.

● Demonstrate critical thinking and problem solving during challenging patient interactions.

● Collect appropriate cost shares and delinquent balances on patient accounts.

● Scheduling and booking of conference rooms.

● Collect required signatures for compliance and regulatory forms.

● Navigate through the Electronic Health Record using Epic.

● Collaborate with internal departments to support the member experience.

● Answered an average of 70 calls per day, addressing customer inquiries, solving problems, and providing new/current product information.

● Focused on meeting and obtaining goals of 80% calls answered in 60 seconds or less and an average speed of answer of one minute or less along with a 92% quality score.

● Provided first call resolution to members and providers.

● Provided email, and chat support to members and potential members addressing non-clinical inquiries.

● Successfully met performance goals while working independently and in a team-based environment when necessary.

● Averaged a 97% average Quality Assurance target.

● Assisted new representatives with peer coaching and call monitoring.

● Initiated contact with the appropriate health plan, medical group, and facility employees to acquire information related to the concern or inquiry.

● Demonstrated knowledge of appeals, grievances, claims, HMO, PPO, Medicare and Medicaid regulations.

● Displayed leadership qualities to handle crisis situations and uphold calm solution-oriented approach when replying to emergency circumstances and difficult calls.