Dynamic Provider Services Specialist with a proven track record at Optum, adept at navigating complex eligibility and benefits inquiries. Leveraging strong data analysis proficiency and empathy, I excel in resolving provider issues and facilitating seamless enrollment processes, ensuring optimal patient care and satisfaction. Committed to delivering results in fast-paced environments.
Provide timely and accurate information regarding patient's eligibility, benefits, other insurance and other relevant topics.
Answer provider inquiries regarding claims status, denials and billing history.
Assist providers with enrollment and network participation.
Escalate complex issues to appropriate departments for resolution.
Assist and gather necessary medical documents to obtain insurance approval for treatments and procedures.
Checking authorization requirement for a procedure.
Assist provider in creating prior authorization, status and clinical submission.
Handles customers inquiries, makes reservation and provide information about hotels and travel packages.
Checking availability rates, amenities and other travel-related questions.
Assist customers in booking hotels, changes of travel and cancellation of trip.
Provide information about hotel policies, activating free night and accumulations.
Addressing customer concerns, complaints and additional requests in a timely and professional manner.
Answering customer questions about products and services.
Assisting customers in finding items.
Providing product information and explaining features and benefits.
Promoting current sales, promotions and loyalty programs.
Handling customers complaints and concerns.
Maintaining products displays and stock levels.
Checking inventory and submitting stock management reports.