Andrea - Profesional en Verificación de Seguros con experiencia en atención al cliente y auditorías

Gestiona llamadas entrantes y brinda soporte técnico y financiero a clientes de manera eficiente.

Realiza auditorías retrospectivas para aseguramiento de la calidad en procesos de atención médica.

Solicita y sigue autorizaciones previas a seguros en diferentes especialidades médicas, asegurando cumplimiento de requisitos.

Forma y apoya a nuevos empleados en procesos y herramientas del sistema de seguros y atención.

Handle Customer Service inbound phone calls., Dispute P2P payments and commercial transactions., Request cash cards behalf customers through the app., Provide tech support to navigate through the app., Refund annual taxes by phone., Promoted as trainer, at that position trained new waves., Provide support to new hires by teaching them the campaign product., Help new hires on nesting process (chat and voice interactions).

Healthcare retroactive audits.

Check patient effectiveness and eligibility., Determined patient responsibility such as Copay, Ded, Coin and OOP., Get patient’s medical records such as office clinic notes, surgical posting sheets, physical therapy notes and radiology procedures., Submit prior authorization request through phone call, fax or insurance portal., Follow up with insurance if additional information is required and send it right away., Follow up on approval determination and upload letters on proper tools., Handle new projects such as Neurology, Orthopedics, Gastroenterology, etc., Promoted as QA, check quality in prior auth reps interactions and provide feedback to get errors fixed., Verify teams productivity and make sure that the goal is reached., Handled meeting with client., Provide support to reps with new cases and help them to obtain auths., Create log in access in new portals.