Experience

eviCore healthcare

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Intake Representative

  • Jan 2017 - Jul 2022

  Handle high call volume from healthcare providers and members for prior authorization cases. Gather and verify essential information for accurate case initiation and expedited authorization. Analyze denial cases, identifying reasons behind denials and suggesting proactive resolutions. Collaborate with providers and insurance firms for denial navigation and appeals. Gain expertise in medical terminology, insurance policies, and authorization requirements. Prioritize patient… Show more Handle high call volume from healthcare providers and members for prior authorization cases. Gather and verify essential information for accurate case initiation and expedited authorization. Analyze denial cases, identifying reasons behind denials and suggesting proactive resolutions. Collaborate with providers and insurance firms for denial navigation and appeals. Gain expertise in medical terminology, insurance policies, and authorization requirements. Prioritize patient privacy and comply with HIPAA guidelines for sensitive data. Communicate effectively with stakeholders including professionals, patients, and reps. Maintain accurate records using proprietary software, exceeding call quality and processing metrics. Support team members for enhanced efficiency and customer experience. Stay updated on healthcare regulations, insurance policies, and best practices through ongoing training. Show less Handle high call volume from healthcare providers and members for prior authorization cases. Gather and verify essential information for accurate case initiation and expedited authorization. Analyze denial cases, identifying reasons behind denials and suggesting proactive resolutions. Collaborate with providers and insurance firms for denial navigation and appeals. Gain expertise in medical terminology, insurance policies, and authorization requirements. Prioritize patient… Show more Handle high call volume from healthcare providers and members for prior authorization cases. Gather and verify essential information for accurate case initiation and expedited authorization. Analyze denial cases, identifying reasons behind denials and suggesting proactive resolutions. Collaborate with providers and insurance firms for denial navigation and appeals. Gain expertise in medical terminology, insurance policies, and authorization requirements. Prioritize patient privacy and comply with HIPAA guidelines for sensitive data. Communicate effectively with stakeholders including professionals, patients, and reps. Maintain accurate records using proprietary software, exceeding call quality and processing metrics. Support team members for enhanced efficiency and customer experience. Stay updated on healthcare regulations, insurance policies, and best practices through ongoing training. Show less



TTEC

• United States
• Outsourcing and Offshoring Consulting
• 700 & Above Employee

• Customer Service Representative and Licensed Insurance Agent

  • Aug 2014 - Jan 2017

  Excelled as a BCBS Customer Advocate, providing excellent service to BCBS and Medicare clients. Achieved exceptional performance scores, exceeding targets, and ensuring high satisfaction and first call resolution. Managed Check by Phone payments, billing, benefits quoting, medical and prescription claims, and internet help desk support for members and providers. Trained in Booking.com project, enhancing hospitality service skills. Adapted to changing project needs, stayed updated… Show more Excelled as a BCBS Customer Advocate, providing excellent service to BCBS and Medicare clients. Achieved exceptional performance scores, exceeding targets, and ensuring high satisfaction and first call resolution. Managed Check by Phone payments, billing, benefits quoting, medical and prescription claims, and internet help desk support for members and providers. Trained in Booking.com project, enhancing hospitality service skills. Adapted to changing project needs, stayed updated with industry trends, and best practices. Collaborated for enhanced team performance and positive work environment. Enhanced communication, empathy, and problem-solving skills for rapport-building and complex query resolution. Show less Excelled as a BCBS Customer Advocate, providing excellent service to BCBS and Medicare clients. Achieved exceptional performance scores, exceeding targets, and ensuring high satisfaction and first call resolution. Managed Check by Phone payments, billing, benefits quoting, medical and prescription claims, and internet help desk support for members and providers. Trained in Booking.com project, enhancing hospitality service skills. Adapted to changing project needs, stayed updated… Show more Excelled as a BCBS Customer Advocate, providing excellent service to BCBS and Medicare clients. Achieved exceptional performance scores, exceeding targets, and ensuring high satisfaction and first call resolution. Managed Check by Phone payments, billing, benefits quoting, medical and prescription claims, and internet help desk support for members and providers. Trained in Booking.com project, enhancing hospitality service skills. Adapted to changing project needs, stayed updated with industry trends, and best practices. Collaborated for enhanced team performance and positive work environment. Enhanced communication, empathy, and problem-solving skills for rapport-building and complex query resolution. Show less