Healthy Benefits Plus Member Support Subject Matter Expert providing in-depth benefit and system knowledge in order to address eligible member inquiries, handle escalated calls, resolve complex issues, while identifying the type of assistance the customer needs. Provides education and status of benefits and eligibility, billing payments, and navigating UHC web portal. Specialized in advising customers on effective ways to utilize health plan benefits, eligible products, rewards, and store locations.Delivered expert guidance to 45-60 UnitedHealthcare members daily, leveraging in-depth knowledge of healthy benefits, reward programs, and system processes, in order to help members live a healthier lifestyle. Advised members optimal use of health plan benefits, grocery discounts, managing phone orders and inquiries, while maintaining a strong focus on quality and customer satisfaction.

Contact center customer service representative with expertise in providing in-depth product and system knowledge to address customer inquiries, resolve complaints, and troubleshoot issues, and offer general information. Specialized in advising customers on effective ways to save and manage healthcare expenses.Handled 45-65 calls daily, provided empathetic support to guide and educate customers about their health savings accounts, flexible spending accounts, and other health benefit financial products. Utilized detailed product and system knowledge to assist with account balances, transactions, contributions, claims, and reimbursements. Ensured customer security through proper authentication and independently resolved complex issues while documenting interactions.Collaborated with team leads and other departments to plan, prioritize, organize, and achieve objectives aimed at enhancing customer service processes.Participated in ongoing training to stay updated on products and services, by maintaining high customer satisfaction and meeting performance goals for call handling time and resolution rates through tailored communication strategies.

Healthcare administrative professional leading clerical and process improvement initiatives in collaboration with physicians and department leadership to optimize office operations. Supervised front office team enhancing staff skills and fostering a positive team culture. Ensured compliance with medical regulations by adhering to policies and procedures across all activities. Skilled in managing provider schedules, office catering, and inventory control within practice management systems. -Front office administration duties include but are not limited to high volume calls and emails, patient eligibility, rejections, denials and maintaining accurate financial records. Ensured smooth and efficient operation, patient confidentiality, and data security through implementing policies and identifying discrepancies, errors, or missing information.-Developed and implemented new office procedures, documentation, and technical manuals simplifying onboarding processes and to establish communication with clinical staff, resulting in improved workflow, team culture, and overall operations. -Verified patient insurance coverage daily, prior authorizations, and facilitated referrals, demonstrating attention to detail, and a commitment to completing tasks. Resolved customer turnover by a 98% active coverage rate and ensured patients received the care they needed. -Independently conducted patient billing audits quarterly, ensuring timely and accurate claim processing by reviewing medical records for coding accuracy, including diagnosis, procedures, and modifiers. Oversaw cash reconciliation, daily charge file, and operational checks and balances, managing patient deductible, co-payments, and insurance reimbursement payments. -Monitored and recorded vital signs for an average of 30 patients daily, ensuring accurate and timely documentation in electronic health records (EHR). Performed vision, hearing, and in-office quotient tests to support accurate patient assessments.