Trustworthy team player seeking an opportunity to expand talents while contributing with solid time management, and problem-solving skills with the ability to create captivating experiences for customers to assist with company growth.
Overview
11
11
years of professional experience
Work History
Remote Representative
Elevance Health
Las Vegas, NV
09.2022 - Current
Maintained high call volume rates of 80 to 100 calls consistently and executed outbound calls
Established business relationship with new and existing brokers
Assisted brokers on behalf of clients accounts
Handled escalations, brokers inquiries such as; claims, billing, benefits, and enrollment
Responded to all member and broker issues, educated brokers on available self service tools and electronic applications
Maintained confidentiality regarding members, brokers, and company information in compliance with company policies and regulatory requirements
Gathered information, assessed and fulfilled callers needs and educated on important policies and procedures
Verified insurance eligibility and coverage for members
Resolved billing inquiries and disputes in timely fashion
Managed members enrollment process, confirming data accuracy and completeness
Updated members information in accordance with company policy and procedure guidelines
Responded to broker requests, offering excellent support and tailored recommendations to address needs
Educated brokers and members about billing, payment processing, policies and procedures
Completed payment transactions
Followed up with brokers about resolved issues to maintain high standards of customer service
Followed through on all critical inter-departmental escalations to increase customer retention rates
Adhered to HIPAA regulations when handling confidential patient information
Managed multiple projects simultaneously while meeting deadlines set by management team members
Provided excellent customer service by responding to inquiries in a timely and professional manner
Assisted in checking members insurance eligibility prior to their appointment
Provided customer service by answering inquiries, resolving complaints, and providing general information to brokers regarding healthcare services
Verified patient demographic information in order to ensure accuracy of data entry
Processed paperwork related to medical claims processing including authorizations, referrals, pre-certifications
Responded promptly to emails, voicemails, and from brokers and other departments seeking assistance or advice
Utilized active listening and communication skills to address brokers and members inquiries and escalate issues to supervisor