Managed a daily volume of 40+ inbound and outbound calls for U.S.-based healthcare insurance members, delivering accurate information on benefits, coverage, and plan policies. Maintained a 90% customer satisfaction score while meeting strict compliance and quality standards.
Processed 20+ prior authorizations, claims, and coverage determinations per day, achieving 95% accuracy and reducing approval turnaround time by 25%. Ensured adherence to HIPAA guidelines and internal policy requirements.
Resolved complex billing and premium inquiries, decreasing escalations by 30% and improving first-call resolution rates by 20%. Collaborated with providers and internal departments to ensure timely claim processing and member satisfaction.
