 Campaign: BCBS Claim Adjuster - Professional, Facility, ITS Claims. Lead and managed a team of claims processing specialist. Oversee the end-to-end claims processing workflow. Ensure timely and accurate processing of claims. Allocate task among team members based on workload and expertise. Act as a liaison between the claims processing team and other departments. Communicate updates, changes, and expectations to team members. Addressed and resolved issues or concerns raised by team members. Handled complex or escalated claims issues.

 Campaign: Patient Services - Radiology and Pathology - Change Healthcare Reviewed claims, checking for accuracy, completeness, and compliance. Investigates medical coding and billing information. Listened calls, checking for compliance issues, errors and discrepancies. Conducted QA talk for updates and discussed trending errors. Attended weekly internal and external calibration. Conducted coaching session with team members.

 Campaign: MyAdvocate - Eligibility for Federal and State funded programs. Take inbound and outbound calls to ask pre-qualifying questions. Assisted members in screening and submitting applications for Government Programs. Answered inquiries about federal and state programs. Reviewed pre-approved applications and finalize the process.*We provide assistance to elderly in applying for a state program that helps them pay for the Medicare Part B.

• Acted as the main point of contact for customers, addressing inquiries, resolving issues, and offering solutions.• Demonstrated empathy and patience in assisting customers with order-related concerns, building trust and satisfaction.• Utilized tracking systems to monitor shipping progress, providing customers with real-time updates.

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