Gloria - Customer & Patient Service Specialist with multi-industry experience
Summary
Dedicated Customer Service and Patient Care Specialist with experience in healthcare, insurance, and customer support environments. Skilled in handling inquiries, managing appointments, and analyzing claims to ensure compliance and resolution.
Key Achievements
- Reviewed and analyzed insurance claim denials to ensure compliance at CCD.
Skills
Delivered prompt and effective support to customer inquiries across multiple channels.
Scheduled and coordinated healthcare appointments ensuring smooth operational flow.
Examined insurance claim denials to identify possible issues and procedural mistakes.
Effectively communicated with customers and healthcare providers via phone, email, and chat.
Maintained accurate records of customer interactions, appointments, and insurance claims.
Languages
Experience
Customer Service Specialist
ALORICA
Identifying and addressing customer complaints or concerns, ensuring timely and effective resolution., Answering customer questions via phone, email, or chat regarding products, services, or company policies for some promotions.
Patient Care Specialist
TRUESHORE
Medical appointment scheduling and agenda management., Manage appointments via phone with various diagnostic centers in the U.S.
Medical Billing
CCD
Review the claim denial notice to understand the reasons for denial (e.g., lack of coverage, missed deadlines, incomplete documentation)., Ensure the claim falls within the scope of coverage outlined in the policy and that the denial is in accordance with the terms and conditions., Look for any administrative or procedural mistakes that may have led to the denial (e.g., incorrect coding, missed deadlines).