Detail-oriented and compassionate healthcare support professional with 16+ years of experience in customer service and public health. Skilled in onboarding new health plan members, verifying eligibility, coordinating with care teams, and using systems such as Epic and CRM tools. Proven success in call center environments, managing large caseloads, and ensuring timely and accurate care access for members. Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
• Managed Medicaid eligibility applications and redeterminations for 150+ clients.
• Performed regular outbound and inbound calls to confirm member status.
• Conducted interviews and documented outcomes in state systems.
• Ensured correct PCP attribution and initiated corrections when needed.
• Assisted with Long-Term Care claims processing and issue resolution.
• Maintained compliance with all federal and state policy updates.
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