Experience

Blue Cross and Blue Shield Federal Employee Program

• United States
• Insurance
• 1 - 100 Employee

• Customer Advocate

  • Mar 2023 - Present

  Richardson, Texas, United States Interact with members and providers to resolve an telephone or written inquiries • Ivaintain complete connaentanty or company Dusiness • Maintain communication with management regarding development within area of assigned responsibilities and perform special projects as required or requested • Efficiently working in multiple systems to complete customer inquiries, Microsoft Office applications, Word, Excel, Outlook, OneNote, and Power Point • Insurance industry terminology including… Show more Interact with members and providers to resolve an telephone or written inquiries • Ivaintain complete connaentanty or company Dusiness • Maintain communication with management regarding development within area of assigned responsibilities and perform special projects as required or requested • Efficiently working in multiple systems to complete customer inquiries, Microsoft Office applications, Word, Excel, Outlook, OneNote, and Power Point • Insurance industry terminology including CPT/Diagnosis codes. Show less



Humana

• United States
• Insurance
• 700 & Above Employee

• CONTACT CENTER REP (CLAIMS & MEMBER PROVIDER SERVICES)

  • Jan 2022 - Feb 2023

  United States • Demonstrating good customer service for each member and provider that calls in and resolving each inquiry, comment, or complaints. • Assist members and providers with questions on benefits, claims, billing, Prior Authorization, and general inquiries on how the insurance works • Maintain good metric numbers to stay compliant with department standards, problem-solving skills with a high level of accuracy • Efficiently working in multiple systems to complete customer inquiries… Show more • Demonstrating good customer service for each member and provider that calls in and resolving each inquiry, comment, or complaints. • Assist members and providers with questions on benefits, claims, billing, Prior Authorization, and general inquiries on how the insurance works • Maintain good metric numbers to stay compliant with department standards, problem-solving skills with a high level of accuracy • Efficiently working in multiple systems to complete customer inquiries, Microsoft Office applications, Word, Excel, Outlook, OneNote, and Power Point • Knowledge of medical and insurance industry terminology including CPT/Diagnosis codes. Show less



Steward Health Care

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

• Customer Service Representative

  • Mar 2020 - Jan 2022

  Richardson, Texas, United States • Providing excellent customer service through inbound/outbound contact center. • Obtaining great metrics and exceeding performance goal for the specific call type • Greet & Assisting members and providers actively and effectively with inquiries and immediate needs following HIPAA regulations • Organize and maintain a clean, efficient, and confidential work area • Schedule patient’s appointments, verify active or inactive insurance coverage enter patient’s demographics, pcp… Show more • Providing excellent customer service through inbound/outbound contact center. • Obtaining great metrics and exceeding performance goal for the specific call type • Greet & Assisting members and providers actively and effectively with inquiries and immediate needs following HIPAA regulations • Organize and maintain a clean, efficient, and confidential work area • Schedule patient’s appointments, verify active or inactive insurance coverage enter patient’s demographics, pcp update, claims research and update members information into the database with accurate documentation from the call. Show less