• Quickly build rapport and respond to plan participants in a compassionate manner by identifying and exceeding expectations by responding in a respectful, accurate, timely manner, consistently meeting commitments via phone, email, and instant message.• Ability to customize customer service approach to meet all types of communication styles and personalities while maintaining professionalism and diplomacy during difficult calls.• Handle confidential information with sensitivity and discretion in accordance with HIPAA and Data Privacy laws and company data security requirements.• Skillfully translate health and welfare and pension terms, complex plan information and processes into simple explanations and instructions that customers can understand and act upon.• Demonstrate knowledge, understanding and compliance with company and client procedures and guidelines providing appropriate and accurate information.• Read and understand client's plan documents and online knowledgebase tools while collecting relevant information to determine immediate requests/questions and to anticipate the future needs of the member.• Maintain and document complete and accurate call and case notes in a professional manner.

• Assisted with contracting medical providers into Texas Medicaid/Medicare plans.• Reviewed backlogs of credentialing requests and applications of current doctors. • Made 50-100 outbound calls to verify doctor location, contact info, and updated provider credentialing.• Knowledge and understanding of the credentialing and enrolment process.• Ability to organize and prioritize work and manage multiple priorities.• Excellent verbal and written communication skills• Excellent attention to detail• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.• Proficient use of Microsoft Office applications (Word, Excel, Access) and credentialing software• Knowledge and understanding of the credentialing and enrollment process.• Ability to organize and prioritize work and manage multiple priorities.• Excellent verbal and written communication skills• Excellent attention to detail• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.• Proficient use of Microsoft Office applications (Word, Excel, Access) and credentialing software

• Provided customer service support & critical issue resolution for YouTube related issues via Twitter.• Used ticketing system to respond & resolve user issues such as: monetization questions, account hacks, and technical problems.• Completed 40 – 80 customer tickets per day by answering all technical related questions.

• Processed incoming prior authorizations from nurses on behalf of Superior Health Plan insurance.• Processed intakes for all Behavioural Health admissions in the state of Texas which qualified for Medicare, Medicaid, and Marketplace services.• Obtained pre-certifications and pre-authorizations for procedures and medications and could include scheduling appointments for outpatient testing with other providers, coordinates patient appointments/orders.• Provide all required medical information to insurance companies as necessary to facilitate the authorization process.• Follow up promptly on insurance determinations regarding submitted requests.• Run system generated reports to verify procedures by insurances requiring authorization are being captured.• Must request, obtain, and document (within current software) all prior authorizations (or denials of same) appropriately and in a timely manner.• Maintain and update internal listing of insurance carriers that require authorization and their processes.• Obtain retro authorizations as needed.• Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements.

• Sorted, stowed, and loaded packages for overnight deliveries.• Created problem tickets for damaged packages for reordering.

• Responsible for making 40 to 50 outbound calls for computer support.• Assisted customers in resolving technical problems regarding their company software and hardware.• Assisted customers with software updates, password resets, network registration, and routing NTT Technicians to further investigate hardware issues.• Answered help desk inbound calls to ensure customer needs are met.

• Independently identify, troubleshoot, document, categorize, and resolve customer issues involving their YouTube TV subscription.• Handled over 50 inbound calls a day.• Offered customer support to troubleshoot customer issues, such as: payment issues, television blackouts, and device management.• Required knowledge in iOS & Android software, smartphone-based applications, Google products, and the TV Streaming market to resolve difficult scenario.

• Processed incoming electronic applications to enroll Medical Providers into the state's Medicaid program.• Responsible for making 40 to 50 phone calls to providers, ensuring that all qualified providers were enrolled within CHIP's guidelines and deadlines.• Verified provider credentials and maintained records of all outreach activities. The role required independent thinking and excellent organizational skills.• Serve to support overall relationship with insurance payors.