Service Sepcialist
CurrentAssisted members with medical and pharmacy inquiries including benefits, eligibility, claims resolution, planselection, enrollment, and self-service options– Answered 25-35 incoming calls daily with a focus on effectiveness, efficiency, quality, customer satisfaction, first-callresolution, and adherence to company standards– Navigated multiple platforms and databases to gather information regarding medical and prescription plans,Claims.– Worked with support resources to resolve complex member issues and escalated issues– Assisted members with navigating Wellsense member websites and applications–Contacted physician offices on behalf of insurance policyholders to assist with appointment schedulingAssist withTA helper line. Providing assistance to call center agentsAdjudicate and reprocess claims that denied incorrectly.