Dedicated Customer Service Representative – Healthcare Specialist with 2 years of experience delivering exceptional support in a fast-paced BPO environment. Skilled in handling healthcare-related inquiries, resolving patient concerns, and navigating insurance and medical service processes with accuracy and empathy. Proven ability to communicate effectively, manage high call volumes, and ensure customer satisfaction in compliance with industry standards. Committed to improving patient experiences through professionalism, active listening, and problem-solving expertise.
Experience: 6 months - 1 year
- Investigate claim status, processing issues, and payment delays. - Explain claims denial reasons and adjustment codes. - Guides provider on correct claim submission or resubmission. - Assist provider in identifying appeal status and next step available.
Experience: 6 months - 1 year
Skilled in accurate and efficient data entry, including updating spreadsheets, managing databases, and inputting information into CRM systems. Experienced in handling confidential data, ensuring data integrity, and using tools like Excel, Google Sheets, and various data management platforms.
Experience: 1 - 2 years
- Skilled in handling both member and provider inquiries. - Assisted member with prescription refills, denials, and authorization. - Investigate claims and appeals denial for medical claims. - Assisted Providers with claims denials and payment information.
“My business would not be able to go forward if it was not for them”
Gaurab - Adhikari
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