Assisted members, patients, and healthcare providers with inquiries regarding health insurance benefits, eligibility, claims, and coverage.

Handled inbound customer calls while providing accurate information and resolving concerns in a professional and empathetic manner.

Verified member information and updated customer records while maintaining confidentiality and compliance with HIPAA and company policies.

Explained healthcare plans, benefits, billing, authorizations, and claims processes to customers.

Researched and resolved customer issues by coordinating with internal departments and healthcare providers.

Documented customer interactions, case details, and resolutions accurately in the company's customer relationship management (CRM) system.

Met established performance metrics, including quality assurance, customer satisfaction, call handling time, and first-call resolution.

Educated members on available healthcare services, resources, and plan benefits to improve their overall customer experience.

Maintained a high level of professionalism while handling sensitive and confidential healthcare information.