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Competencies
Demonstrated experience with Health Insurance Verification & Prior Authorization.
Demonstrated experience with Enrollment.
Demonstrated experience with Patient education.
Demonstrated experience with DME Resupply.
Demonstrated experience with Data entry and tracking.
Education
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Summary
Professional profile
Experience
CPAP Resupply Specialist/CSR
Received over 80 calls from patients, care givers, physicians and insurance agents.. Created and tracked CPAP supply requests.. Made outbound calls to obtain and verify insurance information.. Served as first line of contact for referral client care calls from physician's offices, insurance companies and others.. Maintains referrals and receives and tracks information regarding changes in client status. Enrolled patients on supply on schedule to ensure timely reception of CPAP supplies.. Upsell CPAP supplies/equipment not covered by insurance such as travel unit and cleaners.. Assisted with billing concerns and explanation of benefits.
Enrollment Specialist
Assisted members with Medicare/health plan enrollment, eligibility, benefits and coverage inquiries.. Educated members on plan options, benefits, costs, networks and enrollment requirements.. Processed and verified enrollment applications and member information accurately.. Guided members through enrollment processes while ensuring compliance with CMS and company policies.. Resolved enrollment, eligibility and coverage issues and escalated complex cases when necessary.. Maintained accurate member records and documented all interactions in the appropriate systems.. Protected confidential member information and maintained HIPAA and data privacy standards.. Collaborated with internal departments to resolve enrollment and member service issues.. Provided professional, empathetic and timely customer service to members and prospective enrollees.
Customer Service Representative
Provided exceptional customer service by answering inquiries on account types and banking products, handling an average of 60+ customer interactions daily.. Resolved account discrepancies efficiently, generating corrective actions for issues such as stop payments and address changes, resulting in a 95% customer satisfaction rate.. Maintained up-to-date knowledge of banking products and policies to effectively meet customer needs and foster strong relationships.
Customer Service Representative
Handled incoming borrower, agent and lender calls regarding vehicle loans.. Tracked, verified and updated insurance information via inbound/outbound calls and multiple websites.. Updated members on outstanding CPIs.. Shadowed calls with new hires.
IT Support Specialist
Provided timely resolution for technical issues impacting over 100 clients, improving user satisfaction ratings by 25%.. Facilitated training sessions on new software and hardware, leading to a 30% decrease in onboarding support tickets.. Streamlined IT communication by meticulously documenting system changes and troubleshooting processes.