SEC 275: Foundations- Computers, Technology & Security. GIAC Foundational Cybersecurity Technologies (GFACT)

Resolved benefit plan inquiries as the primary contact for 150+ members via phone and email, achieving a 95% first-call resolution rate and boosting member satisfaction by 18% in post-call surveys.Managed external vendors, ensured compliance with HIPAA regulations while handling and safeguarding protected health information, and meeting regulatory requirements while providing quality care and service to health plan members.Led process improvement projects as a Subject Matter Expert (SME), streamlined data workflows to cut customer wait times for Medicaid waiver authorization by 60% and achieved 96% documentation accuracy.Conducted assessments and root cause analysis to resolve benefit plan and medical coverage issues, reduced non-emergency ER utilization by 20% among assigned members and enhanced overall member satisfaction.Maintained and updated member records across multiple databases with detailed clinical documentation, ensuring compliance with HIPAA and data privacy regulations.Escalated complex, and unresolved issues to supervisors with comprehensive documentation, actions taken, and next steps, leading to faster resolution timeframe from from 72 hours to 48 hours.

Processed over 2500 utilization requests monthly, ensuring timely benefit disbursement to customers within assigned contractual timeframes.Triaged incoming healthcare provider phone inquiries, addressed and processed telephonic authorization requests within contractual timelines, increasing provider satisfaction by 25% as measured in post call surveys. Onboarded and trained new employees, managed supply purchase orders and provided administrative support to 21 nurses.