Billing and Collection associate/Customer Service Representative/Technical Support

Daily Tasks – Inbound Technical Support 1. Call Handling & Customer Assistance * Answer inbound calls promptly and professionally * Verify customer identity and account details * Listen actively to understand the issue and gather complete information 2. Issue Diagnosis * Identify whether the concern is hardware, software, network, or user-related * Ask probing questions to isolate the root cause * Check system tools, dashboards, or CRM for account/device history 3. Basic Troubleshooting * Guide customers through step-by-step fixes such as: * Restarting/rebooting devices * Checking cable connections and power supply * Verifying settings (Wi-Fi, mobile data, configurations) * Running basic diagnostic tools 4. Advanced Troubleshooting * Perform more complex resolutions, including: * Network configuration and reset (IP settings, DNS, etc.) * Software reinstallation or updates * Device compatibility checks * Remote troubleshooting (if tools are available) * Log analysis and error code interpretation 5. Resolution & Escalation * Provide clear instructions and confirm issue resolution * Escalate unresolved or complex issues to higher-level support (Tier 2/3) * Create and document tickets with complete details

Customer Service Representative (Inbound) – Daily Responsibilities 1. Handle Inbound Calls * Answer incoming calls from members, providers, or clients in a timely and professional manner * Verify caller identity following HIPAA and company guidelines 2. Eligibility Verification * Check member eligibility and coverage status * Confirm active/inactive plans, effective dates, and plan details 3. Benefits Explanation * Provide accurate information about plan benefits * Explain coverage limits, co-pays, deductibles, and exclusions * Assist members in understanding their healthcare plans 4. Claims Assistance * Review claim status and processing details * Explain reasons for claim approvals, denials, or delays * Guide callers on claim submission or resubmission process 5. Authorization Support * Check status of prior authorizations * Assist providers/members with authorization requirements * Guide on submitting requests and required documentation 6. Appeals Handling * Provide information on appeal processes for denied claims/services * Assist in initiating or following up on appeals * Ensure proper documentation and timelines are communicated

I have experience as a Billing and Collection Specialist, with a strong focus on end-to-end prior authorization processes. I handled reviewing patient information, submitting authorization requests through various portals, and following up with insurance companies to ensure timely approvals. I am also trained in handling medical necessity appeals and ensuring all required clinical documents are submitted to avoid denials. I am highly organized, detail-oriented, and committed to delivering accurate and efficient work. I believe my skills and experience make me a strong candidate for this role.