For the last 3 years, I have been honing my experience in a call center industry— in which I handled US Healthcare account for both members and Provider services.
In member services, I handled Insurance Verification, Prior authorization, setting up transportation ride for a patient going to the hospital and returning back to their home. Doctor's appointment scheduling, Checking the patient's premiums, Processing Grievance and Appeals and Medication refills.
And in Provider services, I handled credentialing status, checking the eligibility and benefits of the patient, checking the status of prior authorization, and if Prior authorization and PCP referral is required or not. And also, I processed the authorization and fax it to the provider's office. I also checked the claims status and Appeals' status, and processing the GAP exception.
I also have HIPAA certification and I have a knowledge using CRM, Google workspace, Microsoft 365, Availity, Salesforce, Genesys, Avaya, Citrix workspace, VPN, zoom, Skype, Webex. I am actually an expert with those tools since that's what we used on my previous job.
