Working through various channels such as phone, fax, and chat, guides healthcare professionals through the medication prior authorization process.Secures confidentiality of each call using proper HIPAA and PHI guidelines.Identifies and analyzes problems and asks probing questions to determine appropriate solutions.Decides if approval specifications are met and authorizes requests on a case-by-case basis.Provides professional, accurate, and courteous information to all callers.Works cross-functionally to ensure seamless, continuous service and promote strategy development.

Advised and educated callers on healthcare-related inquiries, including claims questions, provider choices, and explanation of benefits.Advocated for each customer by listening closely to needs and finding creative solutions to address and resolve questions, issues, and concerns.After promotion to Customer Relations II, acted as liaison between multiple internal partners, performed initial investigations, and verified credentialing status.Initiated authorizations including those for ER, direct, NICU, Maternity, and OB Global.

Built long-lasting relationships with clients through cold calling, assistance with navigation of services, and reduction of unsatisfactory experiences.Managed social media sites and spearheaded marketing efforts including networking, creating informational postings, and updating product information.Maintained in-depth understanding of products, providing knowledgeable responses to diverse questions.