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Customer Service Representative with 3+ years in healthcare industry
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Competencies
Applied customer service skills to handle inquiries, resolve issues, and provide education about health insurance.
Effectively communicated complex insurance information to customers and guided them through enrollment processes.
Utilized Genesys, Maestro, and Icue to manage customer data and document interactions efficiently.
Addressed customer concerns and issues related to claims, billing, and coverage discrepancies.
Managed multiple requests and inquiries simultaneously within a fast-paced healthcare environment.
Education
Summary
Experienced customer service specialist with expertise in health insurance and healthcare systems.
Key Achievements
- Handled diverse customer inquiries related to health insurance benefits, claims, and enrollment processes.
- Assisted customers in navigating complex health insurance systems and resolving issues related to coverage and claims.
- Utilized multiple software platforms including Genesys, Maestro, and Icue to document interactions and update customer information.
Experience
CUSTOMER SERVICE REPRESENTATIVE - UNITED HEALTHCARE
Answering Inquiries: Responding to phone calls from customers seeking information about their health insurance coverage, benefits, network providers, and claims. The software available to complete the task were Genesys for phone calls and Maestro and Icue for documenting., Assisting with Enrollment: Guiding individuals through the enrollment process for health insurance plans, including explaining different plan options, coverage details, and enrollment deadlines., Resolving Issues: Addressing and resolving customer concerns or complaints related to claims processing, coverage denials, billing discrepancies, or other issues they encounter with their health insurance., Providing Education: Offering information and assistance to help customers understand their health insurance benefits, coverage limitations, utilization management processes, and how to navigate the healthcare system effectively., Processing Requests: Handling requests for ID cards, policy documents, claim forms, and other administrative tasks related to customer accounts., Navigating Systems: Utilizing various software systems and databases to access and update customer information, track inquiries, and escalate complex issues to appropriate departments for resolution., Offering Support: Providing support and guidance to customers during critical situations, such as medical emergencies, by connecting them with appropriate resources or assistance programs.