Dedicated Medical Insurance and Healthcare Operations Professional with over 5 years of experience in customer service, health insurance support, benefits verification, claims management, prior authorization review, and provider relations. Skilled in managing client accounts, handling high-volume inbound and outbound calls, analyzing health plan benefits, and educating members on coverage options, copays, deductibles, coinsurance, and out-of-pocket costs. Experienced in supporting senior populations with patience, empathy, and clear communication while maintaining HIPAA compliance. Strong critical-thinking, problem-solving, and administrative skills with a proven ability to deliver personalized insurance solutions, resolve complex coverage issues, and ensure exceptional client satisfaction.
Core Competencies & Expertise:
Operations & Leadership: Team Leadership, Performance Improvement Plans (PIP), Quality Assurance (QA) Coaching, Adherence & Absenteeism Tracking.
Healthcare & Claims: Healthcare Claim Reconciliation, Billing, RCM, Root Cause Analysis, HIPAA Compliance, Retention Strategies, Appointment Setting.
Technical & Soft Skills: High-Proficiency English Communication, Escalation Resolution, CRM Management, Microsoft Office, and Google Workspace.
Whether you need a dedicated individual to untangle complex claim reconciliations or a seasoned leader to manage, coach, and elevate your customer service operations, I bring the professional maturity and data-driven approach needed to drive your business forward. Let’s connect to discuss how I can streamline your daily operations and boost your team's key performance indicators.
