Sr. Customer Representative / Hybrid LS & Ops Resource
Optum Global Solutions
Oct 2021 - Jun 2025 (3 years 9 months)
• Performing key responsibility areas including but not limited to; Billing and payments, benefits and eligibility,
appeals and grievances filing, decoding claims and handling denials, prior authorization check, provider outreach,
fulfillments and technical support using the following tools: CRM utility bill pay, GPS, Claims Codes & ICES,
ICUE, DOC360, Genesys, MARx, Maestro, DMEVS, RallyHealth, PSP and EWD.
• Receiving inbound calls and doing outbound calls when handling complex concerns of the clients including but not
limited to; claims denial management, referral and prior authorization follow ups, appointment setting and provider
credentialing.
• Cross-trained across 5 LOBs and support the manpower demand of the business by taking the