Detail-oriented Insurance Operations Specialist with 5+ years of experience in healthcare (Medicaid/Medicare) and auto insurance back-office support. Proven expertise in claims processing, preauthorization coordination, audits, and secure payment transactions, consistently achieving 98%+ quality audit scores and 100% HIPAA compliance. Skilled in leveraging CRM systems (Salesforce, Genesys, Avaya) and digital tools to streamline workflows, maintain 99.5% data accuracy, and deliver 100% SLA compliance. Adept at resolving complex coverage inquiries with a 94% first-contact resolution rate, while driving measurable improvements in partner satisfaction. Equipped with a dedicated remote office setup, flexible availability across U.S. time zones, and a strong commitment to accuracy, efficiency, and client satisfaction.
