Customer Service Representative
Jul 2021 - May 2024 (2 years 11 months)
Healthcare Insurance Account
• Assisted members with prescription, medical, and general service inquiries
• Verified insurance benefits, eligibility, referrals, and in-network providers
• Investigated billing, enrollment discrepancies, authorizations, and denials
• Processed cancellations, reinstatements, one-time payments, and auto-pay setup
• Handled escalations and complex member concerns
• Coordinated with pharmacies and provider offices for drug authorization overrides
• Reviewed and filed appeals and complaints