Laurencia Ceballos

Handled multiple tasks and systems simultaneously while assisting clients with credit card concerns.

Process payments and refunds as well as Initiate billing disputes and fraud claims

Educate clients on how to conduct transactions and account maintenance through self service options via online service and mobile app.

Addressed member and provider inquiries efficiently.
Managed and processed requests for prescription renewals.
Create prescription retention requests
Provide medication pricing, coverage and authorization details to callers.
Make outbound calls to members and providers when needed
Coordinated timely delivery of medications to commercial and residential locations.
Assist with side by side training for new employees

Ensure accuracy of pharmacy and medical benefit verifications.
Verified medication claims to determine necessity for Prior Authorization.
Evaluated incoming prior authorization requests through multiple channels.
Conduct outbound calls to providers as necessary.

Assist health plan members with knowledgeable responses to inquiries in a courteous and professional
manner.
Facilitated health plan eligibility verification and benefit information.
Coordinated behavioral health referral services for healthcare plan recipients.
Coordinated efficient transportation services for member appointments and provider meetings.
Facilitated changes in medical appointments for health plan members.
Assist health plan members with placing orders for over the counter medications as well as the process
for ordering durable medical equipment and incontinence supplies.
Supported organization by handling grievance and coverage determination submissions efficiently.