Optum Global Solutions
(Customer Service Representativefor Healthcare Industry)
➢Providing excellent customer service, responding to and resolving customer service inquiries, and determining the topic and type of assistance required by the consumer.
➢Work with support resources to resolve customers and/or partner with others to resolve escalated issues by researching difficult issues across many databases.
➢Multiple platforms and request routing are documented.
➢Locating and contacting in-network providers, as well as scheduling appointments for members.
➢Benefits and coverage were explained, as well as the status of claims and billing questions.
➢In a positive approach, conveyed complex information. Assisting with the submission of grievances and complaints.
➢Advocate for Issue Management: Assisting leadership in delegating follow-up obligations and ensuring deadlines are met.
➢Taking care of the members' monthly payments
Teleperformance Philippines
(Customer Service Representativefor Healthcare Industry)
➢Providing an exceptional customer service experience, responding to and resolving customer service inquiries, and identifying the topic and type of assistance the customer needs.
➢Research complex issues across multiple databases and work with support resources to resolve customers and/or partner with others to resolve escalated issues. Documenting multiple platforms and routing requests.
➢Locating and establishing contact with in network providers and setting appointments for members.
➢Explained benefits and coverage, status of claims and resolving billing inquiries.
➢Delivered complex information in a positive manner. Assisting with filing complaints and grievances.
➢Issue Management Advocate: Helping leadership to delegate follow up commitments and ensure timelines are met.
➢Served as a point of contact for leadership, providing daily updates.
ADVANCE MICROSYSTEMS CORPORATION
(ACCOUNT EXECUTIVE)
➢Entertain clients over the phone by providing extensive information about IT products to potential customers.
➢Closing sales and telemarketing Dealing with customers and vendors. Quotes are being sent out.
➢Make meetings with the IT/Purchasing Manager.
➢Presentations of products
➢The reliever for the receptionist
NTT DATA Philippines
(Intake Specialist)
➢ Insurance Verification
➢Verify whether Prior Authorization is required and assess if Predetermination is recommended.
➢Initiate a case when applicable.
➢Monitor and update the status of the case.
➢Communicate the rationale for case denial and initiate a peer-to-peer request via email.
➢Provide necessary information for the appeal process and track the status of the appeal request.