Customer Service Representative, Prior Authorization Special

• Handles 80+ calls daily with duties including registering new patients, scheduling, confirming and cancelling patient’s appointment or procedures, sending patient’s concerns, inquiries, and requests to the right department, and updating patient’s chart. • Reviewing doctor’s treatment plan for the patient • Verifying patient’s insurance and collecting prior authorizations from providers. • Creating lab and imaging order based upon doctor’s plan and order. • Processing patient’s medication request. • Requesting patient’s medical records from different facilities • Assisting patient to set up Patient’s Portal • Served as SME for new hires and junior agents, providing training and coaching on workflows, systems (EHR), and communication standards. • Collaborated with QA and team leads to identify process gaps, optimize scripts, and improve handling of escalated calls. • Acted as go-to resource for complex cases and system navigation questions from peers.

• Manages physician schedule including scheduling patient’s appointments and procedures. • Monitors, tracks, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery. • Directed incoming calls to internal personnel and departments, routing to best-qualified department. • Submit requests to insurance providers for approval of medications, procedures, or treatments. • Tracks the status of these requests to ensure timely responses. • Check patient insurance eligibility and coverage details • Calls patient to inform them if authorization has been acquired prior to their visit. • Calls patient to reschedule their appointment if no authorization was obtained. • Recognized as SME for Prior Authorization processes, assisting team members with insurance workflows and system updates. • Provided ongoing peer support and shared best practices through team meetings and internal documentation.

• Handled 60+ inbound and outbound calls daily, assisting customers with new service sign-ups, account inquiries, and service cancellations — maintaining professionalism and empathy throughout. • Achieved an 85% customer retention ("save") rate by utilizing persuasive communication, active listening, and value-based objections handling — demonstrating skills transferable to collections and dispute resolution. • Assisted in resolving billing disputes and service dissatisfaction by quickly analyzing account history, offering solutions, and coordinating with back-office teams for issue resolution. • Documented all customer interactions with accuracy in the CRM system, ensuring clear audit trails and minimizing repeat calls — experience relevant to financial compliance and case tracking. • Managed confidential customer data in alignment with company policies and data protection standards, preparing for similar expectations in banking and fraud-sensitive roles. • Maintained high CSAT (Customer Satisfaction) scores through professionalism, product knowledge, and follow-through. • Proactively identified customer pain points and escalated recurring issues to supervisors, contributing to improvements in the customer experience and internal processes. • Memorized the full line of products, pricing, seasonal promotions, and contracts to confidently present tailored service options.

• Handles 80+ calls daily with duties including registering new patients, scheduling, confirming and cancelling patient’s appointment or procedures, sending patient’s concerns, inquiries, and requests to the right department, and updating patient’s chart. • Reviewing doctor’s treatment plan for the patient • Verifying patient’s insurance and collecting prior authorizations from providers. • Creating lab and imaging order based upon doctor’s plan and order. • Processing patient’s medication request. • Requesting patient’s medical records from different facilities • Assisting patient to set up Patient’s Portal • Served as SME for new hires and junior agents, providing training and coaching on workflows, systems (EHR), and communication standards. • Collaborated with QA and team leads to identify process gaps, optimize scripts, and improve handling of escalated calls. • Acted as go-to resource for complex cases and system navigation questions from peers.

• Submit requests to insurance providers for approval of medications, procedures, or treatments. • Tracks the status of these requests to ensure timely responses. • Check patient insurance eligibility and coverage details • Calls patient to inform them if authorization has been acquired prior to their visit. • Calls patient to reschedule their appointment if no authorization was obtained.

• Submit requests to insurance providers for approval of medications, procedures, or treatments. • Tracks the status of these requests to ensure timely responses. • Check patient insurance eligibility and coverage details • Calls patient to inform them if authorization has been acquired prior to their visit. • Calls patient to reschedule their appointment if no authorization was obtained.

• Handled 60+ inbound and outbound calls daily, assisting customers with new service sign-ups, account inquiries, and service cancellations — maintaining professionalism and empathy throughout. • Achieved an 85% customer retention ("save") rate by utilizing persuasive communication, active listening, and value-based objections handling — demonstrating skills transferable to collections and dispute resolution. • Assisted in resolving billing disputes and service dissatisfaction by quickly analyzing account history, offering solutions, and coordinating with back-office teams for issue resolution. • Documented all customer interactions with accuracy in the CRM system, ensuring clear audit trails and minimizing repeat calls — experience relevant to financial compliance and case tracking. • Managed confidential customer data in alignment with company policies and data protection standards, preparing for similar expectations in banking and fraud-sensitive roles. • Maintained high CSAT (Customer Satisfaction) scores through professionalism, product knowledge, and follow-through. • Proactively identified customer pain points and escalated recurring issues to supervisors, contributing to improvements in the customer experience and internal processes. • Memorized the full line of products, pricing, seasonal promotions, and contracts to confidently present tailored service options.

• Handled 60+ inbound and outbound calls daily, assisting customers with new service sign-ups, account inquiries, and service cancellations — maintaining professionalism and empathy throughout. • Achieved an 85% customer retention ("save") rate by utilizing persuasive communication, active listening, and value-based objections handling — demonstrating skills transferable to collections and dispute resolution. • Assisted in resolving billing disputes and service dissatisfaction by quickly analyzing account history, offering solutions, and coordinating with back-office teams for issue resolution. • Documented all customer interactions with accuracy in the CRM system, ensuring clear audit trails and minimizing repeat calls — experience relevant to financial compliance and case tracking. • Managed confidential customer data in alignment with company policies and data protection standards, preparing for similar expectations in banking and fraud-sensitive roles. • Maintained high CSAT (Customer Satisfaction) scores through professionalism, product knowledge, and follow-through. • Proactively identified customer pain points and escalated recurring issues to supervisors, contributing to improvements in the customer experience and internal processes. • Memorized the full line of products, pricing, seasonal promotions, and contracts to confidently present tailored service options.