• Assisted members and patients with inquiries related to healthcare plans, benefits, eligibility, and claims
• Provided clear explanations of coverage, copays, deductibles, and authorization requirements
• Handled appointment scheduling, provider information, and referral assistance
• Processed claims status inquiries, corrections, and escalations accurately
• Maintained strict compliance with HIPAA and data privacy regulations
• Documented interactions thoroughly in CRM and healthcare systems
• Resolved concerns with empathy while ensuring accuracy and confidentiality
• Met quality, productivity, and customer satisfaction benchmarks

• Conducted data research, collection, and validation from multiple internal and external sources
• Analyzed and verified data accuracy, completeness, and consistency
• Performed data cleansing, formatting, and standardization to maintain data integrity
• Compiled research findings into structured reports and summaries
• Utilized Microsoft Excel and other tools to organize, analyze, and present data
• Identified data discrepancies and resolved issues through cross-checking and verification
• Maintained detailed documentation and followed data governance standards
• Met productivity and accuracy targets while handling large data volumes