Shalishe Guster

Record Keeping:

Maintain accurate logs of calls, incidents, and dispatch activities

Providing support and necessary information to field unit

Ensuring compliance with safety protocols and company policie

Excellent communication skills, both verbal and written.

Attention to detail for accurate record keeping and information

Respond to urgent issues, resolve scheduling conflicts, and handle logistical challenges in real-time

Conducted inbound and outbound calls to inform members about products and services.

Reviewed insurance policies to clarify covered benefits for members.

Assisted providers with claims information, utilizing service codes and ICD9/ICD10.

Facilitated member and provider service calls for state Medicaid and commercial health insurance.

Documented details of complaints while excluding payment-related issues.

Assigned members to appropriate medical providers based on needs.

Ensured accurate communication of benefits and services to enhance member experience.