Customer Service Specialist | Healthcare & Property Management | Sales & Collect

Customer Service Advocate (Imperial Health Care Account – In/outbound - WFH) • Answer inbound/ outbound calls using (RingCentral), providing accurate information regarding healthcare coverage plans, benefits, eligibility, and exclusions, in compliance with HIPAA guidelines. • Manage claims processing by investigating policy details, medical records, and documentation to determine eligibility and coordinate appropriate payouts. • Assist with grievance and appeal processes, supporting members with denied claims and reconsideration requests by gathering necessary documentation. • Document customer interactions using (EZ-cap), ensuring accurate and up-to-date records of claims and customer accounts. • Participate in quality assurance initiatives, addressing customer inquiries, and troubleshooting member website issues to ensure satisfaction and compliance with industry standards.

Customer Service Representative (UHC Health Care Account – Inbound - WFH) • Handled inbound and outbound customer calls to provide assistance, resolve issues, and deliver exceptional service. • Demonstrated strong product knowledge and effectively communicated information to customers. • Managed customer inquiries such as benefits & coverage, prior authorization status, appointment schedule (transportation and Dr. appointment), complaints (claim, Appeals and Grievance Medical and Prescription Drug Request denials) , and related requests professionally and empathetically. • Utilized CRM software (Maestro) to accurately document customer interactions and maintain records. Met and exceeded performance targets, including call quality, customer satisfaction, and KPI’s metric.

Verification Of Benefits Representative (Abbott - ACH Health Care Account – Back office) • Responsible for verifying insurance coverage and eligibility for INR home testing patients using CRM software (Sales Force & Patient Connect) to document customer interactions and maintain records accurately. • Contact insurance companies to verify patient benefits and file pre-authorizations if needed. • Process supply orders and maintain accurate patient information such as New Enrolment, Insurance Change, and Reactivation. • Gather necessary medical records, prescriptions and perform other related duties. • PA follow-up, re-authorization, Retro Auth, modification of authorization via phone call, and review correspondence documents.

• Handle customer inquiries and support related to rentals, lease agreements, payments, and account updates via phone, email, and virtual platforms like Call Potential and StorEDGE. • Promote occupancy, enroll customers in Auto-Pay, and sell Protection Plans to meet or exceed sales goals and reduce delinquency rates. • Maintain a CSAT score of 4.5 or higher by delivering professional and timely support, resolving issues efficiently, and encouraging customer feedback through reviews. • Process rental agreements and transactions with over 99?curacy, keep thorough records, and generate reports on customer trends and sales performance. • Operate tools such as StorEDGE, StoreEase, and VMOS to manage tenant accounts, conduct virtual audits, and ensure smooth facility operations.

Depts Collection Specialist (3rd Party Collection Account – Outbound) • Conducted collection calls to customers for overdue accounts, negotiated payment arrangements, and resolved billing disputes. • Prepared and maintained accurate records of customer interactions and collection efforts. • Collaborated with internal teams to resolve complex customer issues and ensure timely resolution. • Achieved collection targets and maintained a high level of professionalism and customer service. • Implemented effective strategies to reduce outstanding debts and improve collection rates.