Helping People Live Healthier Lives Empower health care providers through self help solutions in carrying out eligibility verification and assisting in the utilization of cloud dashboard application for claims submission  Assists providers in determination of claim denial reasons and provides options that yields reconsideration whenever applicable Verifies notification and prior authorization requirements for determination of medically necessary procedures  Reviews… Show more Helping People Live Healthier Lives Empower health care providers through self help solutions in carrying out eligibility verification and assisting in the utilization of cloud dashboard application for claims submission  Assists providers in determination of claim denial reasons and provides options that yields reconsideration whenever applicable Verifies notification and prior authorization requirements for determination of medically necessary procedures  Reviews claims requiring medical/progress notes for health insurance audits  Coordinates with clinical services for procedures that requires pre-determination for qualifying coverage and eligibility of a procedure of health care service Provides benefit information to provider and confirmation of coordination of benefits Contributes positive satisfaction survey results - team and site wide Processes notification requirement for major procedures for both pre and post service Manages peer to peer review requests with medical directors and other health care providers Show less

 Transitioned to provide quality monitoring/improvement for Corporate Office Escalations program with 8-10 headcount handling executive & Better Business Bureau complaints  Transaction monitoring for Voice [recorded, remote or side by side] and Emails CSAT/DSAT report and analysis to improve product/process methodologies Contributes spiels and drafts call flow to effectively address common queries  Does weekly, monthly and quarterly data analysis of overall quality… Show more  Transitioned to provide quality monitoring/improvement for Corporate Office Escalations program with 8-10 headcount handling executive & Better Business Bureau complaints  Transaction monitoring for Voice [recorded, remote or side by side] and Emails CSAT/DSAT report and analysis to improve product/process methodologies Contributes spiels and drafts call flow to effectively address common queries  Does weekly, monthly and quarterly data analysis of overall quality performance Conducts Root Cause Analysis to determine failure points and implement an action plan Conducts training for post nesting agents to calibrate process updates and product knowledge Identifies repeat offenders and suggest a game plan for operations  Does real time coaching and provides suggested strategies to help improve agents performance Calibration call and regular interaction with diverse clients Show less

 Promoted within the pioneer batch as Quality Assurance Analyst monitoring process compliance and providing refresher trainings to strengthen product knowledge of 30-40 headcount with the highest CSAT scores amongst 3LOBs.  Handled escalation calls and processed back office transactions to address and resolve the issue end to end Point of Contact for operation’s daily case report including Open/Close/Escalated cases to assess common call drivers and follow up on pending cases. … Show more  Promoted within the pioneer batch as Quality Assurance Analyst monitoring process compliance and providing refresher trainings to strengthen product knowledge of 30-40 headcount with the highest CSAT scores amongst 3LOBs.  Handled escalation calls and processed back office transactions to address and resolve the issue end to end Point of Contact for operation’s daily case report including Open/Close/Escalated cases to assess common call drivers and follow up on pending cases.  QA Master of the Quarter  Provided assistance to customers by answering common queries on delivery and order status Show less

 Provided technical support for a triple-play telecommunication service Processed back office order issue Consulted by level 2 support & on-site technician for successful troubleshooting of porting glitches  Conducted outbound calls (customers/OEM) to resolve ISP/Engineering conflicts prior to installation of services.  Commended for Communication Skills and CSAT contribution to the center Utilized back end technical services and troubleshooting for resolving order… Show more  Provided technical support for a triple-play telecommunication service Processed back office order issue Consulted by level 2 support & on-site technician for successful troubleshooting of porting glitches  Conducted outbound calls (customers/OEM) to resolve ISP/Engineering conflicts prior to installation of services.  Commended for Communication Skills and CSAT contribution to the center Utilized back end technical services and troubleshooting for resolving order flow issues  Experienced with hardware, software and networking devices Client support and technical issue resolution focusing on quality and first call resolution Security measures to handle confidential customer records Show less

🔸Part time employment for mobile service technical support and billing inquiries.🔸Assists Team Lead in providing support to the team by doing floor support and updates dissemination.