Subject Matter Expert / Admin / Customer Care Representative
Carelon Global Solutions (AnthemElevance Health)
Jul 2021 - Apr 2025 (3 years 10 months)
• Delivered accurate, regulation-aligned information on medical policies, eligibility, benefits, and claims to members, providers, and healthcare professionals
• Composed formal determination letters for appeals and denied claims — requiring precision, legal compliance, and empathetic communication
• Achieved 100% Top Quality scores and ranked as top performer in First Call Resolution (FCR) and CSAT benchmarks
• Contributed to internal process improvements that enhanced team efficiency and client satisfaction
• Certified across 40+ international compliance, healthcare data, HIPAA, and anti-discrimination training programmes