Rochelle Kinter

• respond to inquiries.

• Responded promptly to member inquiries, providing accurate information.

• respond to providers’ questions.

• understand the organization determination, coverage determination, appeals, and grievances processes and route these requests to the appropriate departments

• explain the enrollment and disenrollment process.

• documented caller interactions in membership system to maintain accurate records and facilitate follow-up.

document data for case management and prior authorization verification.

• assist with data for case management, prior authorization verification, and other utilization management activities.

• assist the member with updating their information in the membership system, such as but not limited to their new address or telephone number.

• addressed member inquiries regarding claims to ensure clarity and understanding.

• Answered questions from providers, ensuring timely communication.