Customer Service Representative - Tactical Back Office Inc. - Work from Home (2023-Present)
- Ensure accurate patient records and maintain comprehensive documentation related to Durable Medical Equipment (DME) services.
- Verify insurance eligibility, coverage, and prior authorization requirements for DME through phone calls, web portals, and Availity.
- Coordinate with physicians, clinical staff, and healthcare providers via phone and online platforms to support timely and accurate processing of DME-related services.
Process Associate - Genpact Services LLC (2012-08 - 2022-03)
- Handled inbound and outbound communications with members, medical providers, and dental providers.
- Provided detailed information on medical and dental benefits, eligibility, claims, and pre-authorization requirements.
- Managed performance guarantee (VVIP) accounts, ensuring high-quality and timely service.
- Responded to inquiries via phone and email with professionalism and accuracy.
- Maintained strict compliance with privacy and confidentiality standards when handling sensitive medical records.
Customer Service Representative (CSR) - Sykes Asia, Incorporated (2004-04 - 2011-04)
- Addressed customer inquiries and billing concerns across North America, APAC, and EMEA regions.
- Performed system navigation, account verification, coding, and data entry using CRM tools.
- Processed account updates, cancellations, and reinstatements, ensuring accuracy of billing information. - Completed various administrative and ad hoc tasks as assigned.
- Prepared End-of-Day (EOD) reports, ensuring accuracy and completeness of daily transactions.
- Provided product knowledge and operational support to fellow agents.
- Guided team members in navigating systems and tools such as CCBILL, SVM, AOTS, Manual Charge, and Credit tools.
- Handled supervisory and quality assurance (QA) calls, including escalations.
- Reported support-related issues to clients and escalated concerns as necessary.
- Spearheaded product training sessions and conducted mock calls for new agents.
- Performed manual processing tasks, including chargebacks and retrieval requests.
- Monitored e-fax systems for manual processing work and special billing cases under investigation.
- Maintained and monitored watchlists for revoked accounts.
- Assigned escalated cases to second-level support, ensuring proper documentation and ticket classification.
