Experienced Customer Service Professional with 10 years of total experience. Managed wide variety of customer service and administrative tasks to resolve customer issues quickly and efficiently. Over the years of experience in assisting members with accounts, prior authorization, billing, and Medicaid and Medicare Claims (Appeals and Denials). Educated patients on benefits (EOB) while maintaining confidentiality as per HIPAA guidelines. Addressed an average of 80 customer inquiries and complaints each week. Addressed member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care.