I have been with the healthcare program since 2012 when I joined the BPO industry. From 2012 to 2014 I was part of BCBSNJ as a Customer Service Representative for provider services and promoted to claims adjuster and escalations.
- My tasks and responsibilities were to assist providers with their concerns like eligibility benefits and claims.
-Taking in supervisor calls for escalations and concerns that needs a higher level of assistance.
-To ensure that claims were processed correctly and reprocess if necessary.
From 2014 to 2016 I transferred to a new acquired LOB that time which is the provider network management, and took the role as a team lead assistant.
-The team handles provider requests for demographic changes and credentialing. We provide update regarding the status of their credentialing and any provider data management requests like removal and adding of a physician to their group's file.
From 2016 to 2024 I transferred to BCBSNC and was able to handle several LOBs from 2016 to April of this year.
-To assist members with their concern for billing, enrollment, benefits, eligibility and claims thru phone and email channel.
