First line responder to all provider/members inquiries for Medicaid and Medicare.Acted as advocate for providers/members.Served as educator for providers/members.Answered inquiries from providers regarding benefits, claim resolution, appeal status, and authorization or referral information.Tracked calls and use appropriate systems to provide call documentation and understand eligibility and benefits for all product lines.Resolved complex provider claims and contracting… Show more First line responder to all provider/members inquiries for Medicaid and Medicare.Acted as advocate for providers/members.Served as educator for providers/members.Answered inquiries from providers regarding benefits, claim resolution, appeal status, and authorization or referral information.Tracked calls and use appropriate systems to provide call documentation and understand eligibility and benefits for all product lines.Resolved complex provider claims and contracting issues; worked with internal departments and management to resolve issues and recommend solutions.Supported and provided superior service to provider’s representatives via phones, e-mails, faxes and escalate issues to appropriate parties as requested. Processed paperwork on a timely basis and meet minimum call center production standards.Received inbound calls and make outbound calls depending upon member/provider and management needs.Created and fostered good working with relationships between multiple departments.Linked appropriate resources to members/providers.Maintained proper punctuality and attendance. Show less