Rachell Baker

Provided support for HSA accounts, ensuring top-level performance an customer satisfaction

Adapted to various platforms maintaining flexibility an consistency in service delivery

Flexing between different platforms, our top priority will always ensuring members are being take care of

We offer essential support to multiple lines of bossiness, ensuring top-level performance an growth

Managed phone metrics an ensured first -call resolution fopr all call types, focusing on best practices.

Provided guidance and support for complex issues an customer complaints an ensuring full resolution

Adapted to a fast -paced environment an collaborated with cross-functional teams for career development

Communication, organization an problem solving

Adapt to change in a fast paced enviroment

Take anywhere from 15-40 calls a day

enhanced customer satisfaction by proactively addressing concerns an providing effective solutions.

Handle 25-60 calls daily, demonstrating outstanding service in resolving complex customer issues.

Effectively communicated with patients, provides an insurance companies to ensure resolution of complex claims

Served as a subject matter expert for team members, providing guidance and support for internal customers

• Managed pre-authorization requests to ensure compliance with clinical guidelines.
• Facilitated communication between healthcare providers and insurance teams to resolve utilization issues.
• Analyzed patient data to identify trends in service usage and recommend process improvements.
• Developed training materials for new staff on utilization management protocols and systems.
• improved workflow efficiency by collaborating with health care providers to ensure timely authorizations and discharge planning
• Maintained accurate documentation of all reviews am appeals an decisions organized standards an requirements

• Lead a team of 3, reducing turnaround times for reviews by prioritizing tasks and managing deadlines.
• Approved are denied prior authorizations for dental, DME, and transportation
• Explained an educated customers regarding benefits, assisting them with selecting network doctors..
• Ensured compliance with hoosier Healthwise rules an regulations, addressing customers issues an providing satisfactory resolutions
• Took 60-80 calls a day
• Knowledge of medical terminology, hcpcs code, icd9-codes