Customer Service Representative
Experienced BPO professional with 3 years of expertise in international voice accounts. Specialized in delivering exceptional customer service across diverse industries. Possesses 18 months of dedicated experience in the healthcare sector. Proficient in interacting with providers and ensuring smooth operations by verifying member benefits and eligibility. Exhibits a strong grasp of medical terminology. Assess procedure codes to ascertain their validity and eligibility for billing purposes, concurrently evaluating the need for prior authorization and promptly initiating one when deemed necessary. Meticulously review claims, ensuring accuracy before facilitating reprocessing. Ensure the necessity of a Primary Care Physician (PCP) referral and proactively generate one when warranted. And determine the provider’s network status within the member’s plan. Additionally, possesses 9 months of hands-on experience in the travel domain, demonstrating a deep understanding of travel processes and customer’s needs. And lastly, holds 9 months of experience in financial services, showcasing adeptness in handling financial inquiries and transactions. Renowned for delivering exceptional customer service, leveraging comprehensive industry knowledge to provide accurate and timely responses to inquiries and a dedicated problem solver. Possesses a meticulous eye for detail, coupled with excellent communication and organizational skills, aimed at delivering top-notch service.