Noreen Albert

Resolved customer complaints through effective problem-solving techniques. Assisted in escalating complex issues to appropriate departments for resolution. Utilized system tools to track and manage customer inquiries.

• Provided detailed information and support through inbound and outbound calls concerning benefits and programs.
• Assisted individuals in understanding health plan rewards and wellness programs. Supported clients in navigating program benefits and incentives. Guided participants in achieving wellness goals through program engagement.
• Assisted members in navigating program options and completing enrollment procedures.
• Assisted members in effectively utilizing benefits through comprehensive guidance on cards, apps, and rewards.
• Addressed and resolved issues related to eligibility claims and access.
• Recorded all interactions with precision and attention to detail.
• Addressed customer complaints with empathy, fostering loyalty and encouraging repeat business.
• Navigated high-stress situations with composure, ensuring professionalism while resolving disputes and conflicts.
• Cultivated strong customer relationships through active listening techniques, enhancing client retention and satisfaction.
• Facilitated customer navigation of company website and streamlined online order placement.

• Answer inbound calls from members
• Explain how the Healthy Benefits card or app works
• Help with account issues, balances, and eligible items
• Guide members on how to use their credits (online or in-store)
• Help troubleshoot declined transactions
• Educate users about covered products (e.g., groceries, OTC health items)
• Verify member information securely
• Document interactions in company systems
• Navigate internal databases and tools
• Use CRM software to log cases and track resolutions

A Service Navigator helps members:

• Understand their healthcare benefits
• Access medical, social, or community services
• Navigate the healthcare system more easily
• 📞 Member communicationHandle inbound/outbound calls to assist members with questions
  Provide guidance on benefits, services, and next steps
  
• 🧾 Care coordinationHelp schedule appointments and follow-ups
  Connect members with providers, pharmacies, or specialists
  
• 🧠 Education & supportExplain treatment plans, medications, or preventive care
  Encourage compliance with care plans (e.g., screenings, medications)
  
• 🔗 Resource navigationLink members to community resources (housing, food, transportation, etc.)
  
• 📝 DocumentationRecord all interactions accurately in systems
  Track member progress and outcomes
  
• 🤝 CollaborationWork with nurses, case managers, and providers
  Help remove barriers to care (transportation, cost, access)
  

🔹 Main Responsibilities Achieved operational efficiency through effective management of daily tasks. Enhanced team productivity by streamlining processes. Fostered a collaborative environment that improved project outcomes.

• Handle incoming calls, chats, or emails from customers (members/patients)
• Help customers understand:Insurance benefits
  Claims (approved, denied, status)
  Billing or payments
• Resolve issues on the first call when possible
• De-escalate upset customers professionally
• Document all interactions in company systems
• Escalate complex issues to supervisors if needed
• Protect confidential health information (HIPAA)
• Answer high-volume calls (often back-to-back)
• Look up customer accounts and policies
• Explain coverage, deductibles, and services
• Assist with claim disputes or questions
• Enter notes and update records after each call
• Occasionally upsell or suggest services (depending on program)
• Resolved customer inquiries through multiple channels, ensuring timely and effective communication.