Assisted patients and healthcare providers with benefit verification, claims processing, and policy coverage questions. Navigated HIPAA-compliant systems to access patient records and process authorizations. Educated members on healthcare plan details, billing issues, and service availability. Resolved escalations professionally while maintaining compliance with healthcare protocols. Contributed to team success by meeting quality assurance and call efficiency metrics.

Experienced Member Services Representative at Optum with a strong background in providing exceptional customer support in the healthcare industry. Handled a high volume of inbound calls, assisting members with inquiries about benefits, claims, eligibility, and provider information. Demonstrated excellent communication and problem-solving skills while maintaining a compassionate and professional approach. Adept at navigating multiple systems to provide accurate, efficient service and ensure member satisfaction. Committed to delivering quality care and support aligned with company mission to help people live healthier lives.