- Review members plan to determine eligibility for services.
- Document CRM system with all interactions.
- Communicate with providers and inform them of eligibility and benefits.
- Inform members and providers of reason for denial of claims.
- Provide excellent customer service while assisting providers and members.
- Detect errors made on claims and send for reprocessing.
- Utilize resources and analytics to determine solution to problems.
Member Services Analyst
- Managed calls from members within the member experience umbrella.
- Documented CRM system with all interactions.
- Identified and accessed members needs to achieve satisfaction.
- Built sustainable relationships and trust with members through open and interactive communication.
- Provided accurate, valid and complete information by using the right methods and resources.
- Provided excellent customer service.
- Managed inventory of assets and supplies.
- Sent out and received mail and packages.
- Performed multifaceted general office support.
- Conducted precise and accurate data entry.