I am experienced in Member and Provider Services, providing support to health plan members and healthcare providers by explaining benefits, coverage, and claims information in a clear and accurate manner. I assist members with inquiries related to eligibility, claims status, prior authorizations, and plan benefits, ensuring they understand their healthcare coverage.
I also provide medication-related support to members, including assistance with prescription benefits, coverage verification, formulary checks, copay information, and guidance on pharmacy-related inquiries to help members access their medications efficiently.
Previously, I worked in medical records retrieval, where I handled requests for patient medical records, verified required documentation, ensured HIPAA compliance, and coordinated with healthcare facilities to obtain complete and accurate records within required timelines.
In addition, I have basic technical support knowledge, assisting users with common system and account issues, troubleshooting basic technical concerns, and navigating online portals. I am also experienced in handling email inquiries, responding professionally and promptly while maintaining quality customer service standards.
