Sarah Poitier

Complaint to Medicare (CTM Project):

• Reached out to members daily to offer assistance with any concerns.
• Handled escalated calls, providing solutions to complex issues.
• Maintained detailed records of member interactions and resolutions.
• Explain insurance policies, coverage details, and benefit information clearly
  and comprehensively

Direct Member Reimbursement (DMR Project):

• Assisted members with obtaining missing information for claims.
• Researched documents submitted to the claims department to identify missing information.
• Contacted healthcare providers to retrieve necessary information.
• Communicated findings to claims processors and members to ensure timely claim processing.

Post Call Surveys (PCS Project):

• Listened to recorded calls and provided coaching to representatives on improving service quality.
• Contacted members to resolve issues that were not adequately addressed by initial representatives.
• Ensured member satisfaction by finding resolutions to unresolved issues.

West Elevated Experience Inbound Project:

• Assisted with calls related to the California Individual Physician Association.
• Provided high-level support and resolved escalated issues efficiently.
• Ensured accurate and timely information was delivered to members and healthcare providers.

• Answered customer telephone calls promptly to avoid on-hold wait times.
• Explain member rights and responsibilities in accordance with contract
• Guide the member through their plan benefits and processed claims, referrals, complaints
• Answered constant flow of customer calls with minimal wait times.
• Responded to customer requests for products, services, and company information.

• Supervised employees and oversaw quality compliance with company standards for food and services.
• Helped foster culture of customer centricity by aligning with product, marketing, operations, finance and executive teams to drive initiatives centered on customer success
• Cooperated with coworkers to improve customer experience and manage storefront.
• Checked building to confirm maintenance and cleaning met code and regulations.