Albert James Email & Phone Number

Plainfield, Nj, Us

Plainfield, Nj, Us

New Jersey, United States

• Develops and maintains knowledge of programs and customer workstreams; broadened program knowledge over time.• Learned and utilized protocols to respond to customer phone, chat, fax, intelligent chatbot, SMS, text, mail, and e-mail inquiries as well as other communication channels in a prompt and courteous manner.• Prepared proper documentation and notifications; perform proper escalations, tracking, and follow up.• Works with support and product teams to transfer customers to other units as needed - ensure that referrals are addressed in a timely, consistent, and organized manner to avoid the delay of care for the patient.• Evolved skills to provide detailed resolution regarding program specialties over time. • As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Team Leads.

Bedminster, New Jersey, United States

• Answer incoming phone calls from healthcare providers, clients and members nationwide and identify the type of assistance the customer needs regarding health insurance claims. • Attempt first call resolution through provider education on both inbound and outbound calls.• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems• Attempt first call resolution through provider education, and by researching and exploring answers and alternative solutions; implementing solutions with leadership; escalating unresolved problems to the appropriate department.• Required to meet specific call center performance metrics of productivity and quality assurance.• Performs other job-related duties as required.• Maintain awareness of and ensure adherence to Zelis standards regarding privacy.• Ensure compliance with HIPAA regulations and requirements

Morristown Nj

• Assisted consumers to conduct medical and prescription benefits investigations to reduce drug cost. • Assisted HCP’s through prior authorizations and tier exceptions as well as formulary exceptions.• Learning, understanding and following all company/client's policies and procedures such as adhering to SOP’s.• Evaluated the quality of Customer Service Associates' calls from customers; provides feedback to reps on strengths and areas for improvement.• Demonstrated proficiency to focus on details, handle multiple tasks and remain highly organized in a fast paced environment.• Maintained high levels of performance for customer service metrics including: call answer rate, call quality, customer service ratings, order accuracy, etc.• Plan work schedules and assign staff to accomplish daily work by providing for variations in workload.• Respecting and maintaining privacy and dignity of patients, maintaining and assuring patient confidentiality at all times according and in compliance with HIPPA.• Entered and pulled information using CRM tools.• Handled complex calls as well as escalated calls that are received in the call center.• Created and run reports that will show weekly calling progress in a clear, concise manner to be presented to the director of customer service as well as clients. • Assisted team members with technical support.

Jersey City, New Jersey

• Responds to provider questions via telephone and written correspondence regarding insurance benefits, eligibility and claims. • Analyzes various claims issues and provides information/solutions. • Thoroughly documents inquiry outcomes for accurate tracking and analysis. • Develops and maintains positive provider relations and coordinates with various functions within the company to ensure provider requests and questions are handled appropriately and in a timely manner. • Researches and analyzes data to address operational challenges and customer service issues. • Uses computerized systems for tracking, information gathering and troubleshooting. •Completes interviews with potential employees.

Florham Park, New Jersey

● Receive and effectively route program “referrals” (prescriptions)● Develop contacts within each member pharmacy in order to maintain the most current status on referrals● Maintain tracking documents and crosscheck to ensure platform/tracking document accuracy● Provide weekly/monthly updates to manufacturer regarding referral status● Interface with programmers as needed to address any system difficulties● Communicate with manufacturers, insurance companies, pharmacies and patients to achieve program goals● Attend manufacturer meetings to support ongoing program development● Establish effective rapport with other employees, clients, physicians, and pharmacies

Somerset, Nj

•​Resolved 50-80 patient calls daily.•Insure adherence to the program SOPs and business rules.•​Handle escalated calls into the PAP call center.•​Interacted with distribution center.•​Processed patient refills and applications by phone.•​Troubleshoot internal processes.•​Interact with IT/IS department.•Work in conjunction with Manager regarding day-to-day activities and continuous process design improvement.•​Conducted QA on calls and provided feedback to representatives.

Jersey City, Nj

•​Resolved 65-75 customer calls/emails per day related to products offered on website.•​Investigated and resolved account-specific issues related to order shipments.•​Assisted management in the development of department methods and procedures.•​Processed customer orders by phone.•​Worked closely with the IT team to resolve website issues as necessary for quick resolution.•​Reported all product and service-related trends to the Customer Care Managers.•​Generated UPS Delivery Intercepts, Return Authorizations and/or claims as necessary.•​Assisted in the fulfillment of periodic marketing promotions.•​Other general administrative duties (e.g., filing, data entry, etc.) as assigned.

West Orange,Nj

•​Met with customers and prospects and developed understanding of other financial objectives and needs•​Maintained strong product and sales knowledge and champions core service values•​Provided sound advice at every Customer interaction to create a positive Customer Experience and ensures that the Customer’s financial needs are met•​Responsibly meeting and exceeded specific individual sales goals•​Provides exceptional Customer service by meeting all Customer demands as they relate to relatively straightforward inquiries, with the support of more experienced personnel•​Generally resolved problems independently, escalating more difficult issues to supervisors•​Performed a broad range of tasks of varying complexity and scope•​Ensured Customer problems are handled appropriately, escalating issues when necessary, knew when to consult Managers.•​Engaged Customers in conversations regarding their current and future financial needs. Educated customers about bank products and services