Susie Covert

• Responded to everyday plan benefit questions and documents requests from customers and providers via phone and written correspondence (email, faxes, mail).

-WDS and DDS Routing

-RightNow (webs)

-Incoming faxes (claims)

-RR Donnelly (CT EOC's)

-Dental Documents (urgent fax)

-On Demand (EOBS)

-Eliza (Clinical Integration)

-3rd Party Letters (DMHC)

• Navigated systems and provided customer service in accordance with established expectations and service time frames.
• Submitted electronic/paper claims documentation for claims processing.
• Used training documents and guidelines and as resource to complete assignment or special project.
• Collaborated with team members to develop training guides for consistent customer service delivery.
• Assisted with refresher training sessions for Customer Service Representatives on DMHC procedural updates to help with compliance.
• Cross-trained and knowledgeable on Dental plan platforms for DDS, WDS, and Empire products.
• Followed-through on all urgent dental inquiries/follow up that are out of scope for SIU and Help@anthem.com.
• Helped to prepare reference for DRU consultants in preparation for P2P call backs for DRU consultants.

• Utilized active listening, interpersonal and telephone etiquette skills when communicating.
• Handled customer inquiries and suggestions courteously and professionally.
• Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
• Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
• Responded to customer requests for plan information, updates, and documents.
• Participated in team meetings and training sessions to stay informed about product updates and changes.
• Utilized computerized systems to manage and record interactions.
• Investigated and resolved customer inquiries and complaints quickly.
• Maintained up-to-date knowledge of product and service changes.
• Increased efficiency and team productivity by using training documents and reference guides.
• HIPAA and Confidentiality Compliance