Customer Service Representative with 5 years of experience in healthcare and administrative support, adept at managing high-volume call center operations and resolving inquiries efficiently. Demonstrates strong communication and problem-solving skills, ensuring compliance with HIPAA regulations while facilitating patient access and benefits understanding. Skilled in de-escalation and teamwork, consistently improving service quality through detailed feedback analysis and innovative solutions.
• Managed patient cases from submission to resolution, ensuring timely access to healthcare services.
• Conducted benefit investigations, authorizations, and appeals for patient coverage.
• Reviewed patient documents for completeness and accuracy to support care plans.
• Assisted members with benefits questions, claims accuracy, and policy updates.
• Guided patients through healthcare options, improving understanding of services.
• Ensured compliance with HIPAA regulations while handling sensitive information.
• Handled high-volume inquiries, documenting cases and ensuring accurate data entry.
• Resolved patient/client issues with empathy and professionalism.
• Strengthened service quality by implementing systematic tracking and feedback analysis.
Certified Medical Assistant Program
Microsoft Office Specialist Certification