Annabel Ehiaze

Arlington Tx *****

Email :ad44wu@r.postjobfree.com

Cell 817-***-****)

Customer-focused and empathetic professional with 8+ years of experience in customer services/insurance adjuster. Able to build a sustainable relationship of trust through open and interactive communication with potential new members and securing member retention. Directly answer customer inquiries regarding services promotions, service questions, and general client concerns. Demonstrate, support and coordinate with management personnel regarding the identification of problems, data management, and provide problem-solving . Handle customer objections, provide appropriate solutions and alt

TECHNICALSKILLS

Information entry. ●CRM/collaborationtools (Salesforces, Zendesk, Vtiger, Microsoft Teams, slack ) Electronic Health Records (EHR) Systems (Care360), Healthcare Mobile Applications (Medi safe)

● Document Conversion.

● Inquiry Requests.

● Customer Service and Assistance.

● Customer Data Confidentiality.

● Microsoft Exchange.

● Scheduler

● Call Volume and Quality Metrics.

● Policy and Procedure Adherence.

● Complex Product Knowledge. ● Answering Excellent

● Ability to learn quickly. ●ClaimXperience.

Professional SKILL

Extensive experience in customer service roles, with a focus on healthcare industry standards and practices.

• Strong communication skills, both verbal and written, with the ability to effectively communicate complex medical information in a clear and concise manner.

• Proficient in using customer relationship management (CRM) sowarean contact center technologies to efficiently manage customer inquiries and provide timely resolutions.

• Excellent problem-solving skills, with a demonstrated ability to address customer concerns and resolve issues in a professional and empathetic manner.

• Ability to work collaboratively in a team environment while also independently managing tasks and responsibilities.

• Solid understanding of HIPAA regulations and patient confidentiality protocols.

• Proficient in using customer relationship management (CRM) sowarean contact center technologies to efficiently manage customer inquiries and provide timely resolution

•Analytical Skills: Attention to Detail, Negotiation Skills Customer Service Skills, time Management, Problem-Solving Abilities, Knowledge of Insurance Regulations, Technical Proficiency, Adaptability, Interpersonal Skills

EXPERIENCE

TATA CONSULTANT June 2022 March 2023

Responsibilities

Update accounts with new or corrected information; request itemized statements &/or re-bill claims when appropriate.

•Utilize analytical thinking for account research and reconciliation.

• Manage all interactions in a positive, caring manner. Perform specialized tasks as assigned by the manager and/or supervisor.

Respondtoinboundcalls, emails, and chats from patients, caregivers, and healthcare providers regarding inquiries, appointments, billing, and other healthcare-related concerns.

• Provide accurate and timely information to customers regarding healthcare services, insurance coverage, and medical procedures.

• Assist patients with scheduling appointments, coordinating referrals, and accessing medical records through electronic health record (EHR) systems.

• Address and resolve customer complaints and concerns in a professional and empathetic manner, escalating complex issues to appropriate departments when necessary.

•Collaborate with healthcare professionals and insurance companies to facilitate communication and ensure seamless coordination of care for patients.

•Document all customer interactions and maintain detailed records in CRM system, ensuring accuracy and compliance with privacy regulations.

•Participate in ongoing training and development programs to stay updated on healthcare industry trends, policies, and procedures. Collect payments and/or provide guidance on payment options for outstanding balances, receive and bring to resolution up to 60 calls daily in a fun, fast paced, metric-driven environment.

• interact directly via phone with patients, affiliate partners, payers, and healthcare providers. Everis claims Adjuster 2020 _ April 2022

Responsibilities

InspectingDamages:Conduction-siteinspections to assess anddocumentdamagesto property, vehicles, or health-related issues, depending on the type of insurance.

• GatheringInformation: Interviewing policyholders, witnesses, and involved parties to collect relevant information about the incident or loss.

• Interpreting Policies: Analyzing insurance policies to determine coverage limits, exclusions, and conditions applicable to the claim.

• PreparingReports:Creating detailed and accurate reports outlining the findings of the investigation, supported by photographs, documents, and other evidence.

• Record-Keeping:Maintaining comprehensive records of all interactions, assessments, and decisions related to the claim. • AssessingDamages:Calculating The Cost Of Damages Or Losses,including property repairs, medical expenses, or other applicable costs.

• DeterminingValues:Evaluating the fair market value of damaged property or a reasonable cost of medical treatments.

• Investigating Liability: Determining the extent of liability and responsibility for the incident or loss, considering policy terms and legal regulations.

• CustomerInteraction: Communicatingwithpolicyholders, claimants, legal representatives, and other stakeholders in a professional and empathetic manner.

• ExplainingDecisions: Clearly and effectively communicating claim decisions, coverage details, and settlement offers to all relevant parties.

• Negotiating: Engaging in negotiations with claimants, contractors, or other parties to reach fair and satisfactory settlements.

• SettlementProcessing: Overseeing the settlement process, including the release of funds or coordination of repairs.

• ConsultingExperts: Collaborating with specialists such as engineers, medical professionals, or legal experts for a more in-depth understanding of complex claims. EnsuringCompliance:Adheringtoinsurancelaws,regulations, and industry standards in all claim handling processes.

TELL WORKS LOGISTICS

customer service representative 2017_ 2020

Responsibilities

•Assisted patients with insurance inquiries, claims processing, and billing disputes, ensuring accurate and timely resolution of issues. •Educated customers on healthcare plans, coverage options, and eligibility requirements, helping them make informed decisions regarding their healthcare needs. •Processed referrals and authorizations for medical services, coordinating with healthcare providers and insurance companies to ensure timely approval and scheduling.

•Managed a high volume of incoming calls and correspondence in a fast-paced contact center environment, consistently meeting or exceeding performance targets for customer satisfaction and resolution times •Worked collaboratively with cross-functional teams to identify process improvements and enhance the overall customer experience. EDUCATION AND TRAINING

Associate degree/Diploma: International Studies in Economics Education Valid all line Adjustment Licenses

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