Alexis R. Email & Phone Number

United States

Dallas, Texas, Us

-Monitors and reports on network utilization to internal and external stakeholders. -Reviews PowerBI dashboards to identify trends and recommends interventions.-Prepares summary reports for distribution to stakeholders. -Analyzes network adequacy and recommends recruitment opportunities. -Aggregates and summarizes payor non-participating data for distribution to internal teams.-Prepares educational documents for providers and operators.-Supports other recruiting and ad hoc network operations projects as needed.

Us

• Manages +100 complex short-term disability and concurrent leave of absence cases, consistently meeting deadlines with a 99.2% quality score.• Collaborates effectively with claimants, clients, and medical providers, ensuring clear communication and maintaining confidentiality.• Utilizes advanced applications and databases to analyze policies, resulting in accurate benefit determinations and client retention.• Facilitates onboarding and training for new team members on policies, procedures, and compliance guidelines.• Conducts case audits to ensure precise processing of waiting periods and benefit payments.

Woonsocket, Ri, Us

• Processed and managed an average of 30 medical claims daily, exceeding performance metrics with a focus on accuracy.• Conducted in-depth research to identify and resolve complex claim processing issues, showcasing advanced problem-solving skills.• Applied comprehensive knowledge of medical policies and benefit plans to successfully adjudicate complex claims that couldn't be automated.• Collaborated effectively with internal and external stakeholders to ensure accurate and timely claim processing.• Demonstrated expertise in categorizing and resolving pricing, payment, plan application, and non-benefit-related errors for improved operational efficiency.

Birmingham, Alabama, Us

• Built and maintained strong relationships with internal and external stakeholders, ensuring satisfaction and successful partnerships.• Proactively resolved customer complaints and reported issues, improving service standards, and enhancing the overall customer experience.• Assisted in new employee training, utilizing call shadowing and coaching techniques to support their development and success within the team.• Provided valuable feedback during monthly group call calibration sessions, contributing to the team's commitment to excellence in quality standards.• Consistently exceeded performance metrics by maintaining a minimum 98% quality score for over 4 years in a high-volume call center environment, resulting in exceptional customer satisfaction levels.• Provided technical support to customers, guiding them through website/app navigation, troubleshooting issues, and resolving username/password support requests.

Dallas, Tx, Us

• Exemplified expert knowledge of cellular, internet, and cable products to effectively address customer inquiries and resolve concerns, resulting in significantly improved customer satisfaction.• Conducted thorough research to identify root causes of billing, service, and account-related issues, enabling prompt resolution for valued customers.• Implemented successful strategies to retain customers, resulting in reduced churn and increased customer loyalty.• Utilized consultative selling techniques to understand and meet customer needs, leading to successful sales and upsell opportunities.