Customer Service Representative
• Resolved customer and provider issues with care and concern• Showed initiative and resourcefulness in solving problems and meeting customer needs• Resolved customer service billing complaint• Checked to ensure that appropriate changes were made to resolve customer problems• Referred unresolved customer and provider grievances and appeals to designated departments for further investigations• Discussed members drug coverage, co payments, and tier levels• Reviewed members Medical Benefits and discussed medical claims• Well knowledge of HIPAA standards