CSR/ Quality Analyst/ Medical VA/ Appointment Setter

Overview

Looking for full-time work (8 hours/day)

at $5.00/hour ($880.00/month)

Bachelors degree

Last Active

October 1st, 2024 (42 days ago)

Member Since

July 13th, 2022

Profile Description

In today’s world, companies know that strong, personalized customer service is key to business growth. As an accomplished professional with more than 5 years of experience maximizing customer satisfaction through exceptional customer service, I possess a breadth of knowledge and talents that will allow me to contribute to your business' success through this role. I graduated with honors "Magna Cum Laude" with a degree of Bachelor of Arts in Communication.
Through my work-related and educational experiences, I have expanded my abilities and was promoted to a Call Center Quality Analyst post. I am responsible for direct individual and team leadership to achieve success in a call center environment including coaching, development, and documented one on one sessions. I do random audits for all splits under Medical, handle recoupments both for outbound, inbound and back office, and do presentations of markdowns and mock calls. I am trained for authorization, dental claims, and recoupment account.

SERVICES OFFERED:
Customer Service
Analyzing Calls
Call Audits
Administrative Support
Data Entry
Team Management
Phone Support<8efe80624d780eba0c6493ec45140364>Email Handling
Online Research

EXPERT WITH:
Google Applications
Microsoft Excel
CRM
Verint

I have outstanding problem-solving skills that allow me to respond to customer complaints or issues in a professional manner and offer resolutions. I always strive to improve my skills, learn on the job, and deliver enjoyable customer experiences. Simply drop me an inbox and let's explore the possibilities of something lucrative in doing business together!

Work as Quality Analyst
1. Made sure that the client's standards are met through auditing and giving
timely feedback and coaching when necessary.
2. Assist in creating weekly and monthly reports.
3. Facilitate weekly and monthly huddles with operations and clients.
4. Collaborate with Operations, Training, and Process teams in making sure
that the client's standards are met.
5. Collaborated with other teams and onshore counterparts in solving escalated
issues.
6. Assist in taking in calls when the call volume is high.
7. Integrity in auditing the agent’s call workflow.
8. Provide feedback to onshore counterparts regarding audit results.

Work as CSR
Trained in inbound, outbound, email, chat, and written correspondence.
1. Catered to calls regarding member Eligibility and Benefits Disputes.
2. Catered to calls regarding provider Claims.
3. Took in Escalated calls for a time.
4. Catered to calls regarding Authorization (authorization of codes and
creation of authorization)
5. Catered to calls regarding Dental Claim (Commercial Plan)
6. Financial account under provider payment integrity "recoupment" dealing
with providers disputes,
7. Refund check
8. Commercial and Medicare plans
9. Corrected claims
10. Offset details
11. Coordination of benefits
12. Home health
13. Hospice
14. Split bill
15. DME
16. Multiple surgery reductions
17. Unbundling services,
18. Coding issue
19. Clinical trial /Clinical Issue
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21. IPA
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23. Technical denials
24. Orthonet
25. Ambulance
26. Covered and non-covered services
27. Fax
28. Home-based claims
29. CMS Guidelines
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31. Payments
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33. Prepayment
34. Strict adherence and compliance with the HIPAA policy

Skills
• Microsoft Word / MS Teams / Excel / PowerPoint / Outlook
• Team Player
• Problem-solving
• Attention to detail
• Computer literate
• Communication (oral and written)
• Office experience
• Administrative experience
• Time management / Flexible
• Phone etiquette
• Data entry
• Advanced skills in auditing calls.
• Customer Handling
• Customer Satisfaction
• Excellent problem-solving
• Email management
• Avaya / Ring central
• Verint
• CCM connect portal
• Availity
• Citrix
• Canva
• CRM salesforce