To gain experience and provide growth in my knowledge and develop my skills.
● Resolve customer and providers inquiries and complaints such as, changing their physicians, pharmacy. issues, eligibility issues, assist with member being balance billed, update member’s demographics etc.
● Assist with providers regarding benefits, claims and hospital admissions.
● Specialized in assisting Health Net Appeals and Grievance department by revising member’s complaint and making sure a resolution can be done in a timely matter.
● Participate in various training and team activities to enhance skills and develop to achieve our department goals.
● Follow policy &procedures in assuring documentation is complete in a timely matter and following HIPAA rules and regulations.
● Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
● Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
● Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
Responded to customer requests for products, services, and company information.
● Professional
● Self-motivated
● Client relations
● Extremely organized
● Client-focused with a Positive Attitude
● Fluent in Spanish, writing and spoken
● Quick learner
● Great communication skills
● Customer satisfaction
● Multi-task management
● Team player