
Results-driven professional with over 19 years of experience in optimizing productivity, efficiency, and service quality across diverse environments. Possesses a strong analytical mindset and meticulous attention to detail, excelling in enhancing business outcomes through effective data management, medical support, and comprehensive reporting. Proven ability to implement innovative solutions while fostering collaboration among cross-functional teams to achieve operational excellence. Eager to contribute expertise in a dynamic organization that values high performance and offers opportunities for professional growth.
Responsible for reviewing requests by mail, telephone, or in person regarding insurance claims/policies. Fully proficient in all key areas; performs many complex functions. Primary duties may include, but are not limited to: Responds to inquiries from policyholders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Outbound calls are conducted in the ZipDrug business area. Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary. Performs other duties as assigned. Requires a HS diploma or equivalent and a minimum of 3 years of the company's experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.