Experienced Provider Service Agent with a proven track record in managing provider relationships and resolving complex inquiries at Concentrix. Demonstrates expertise in benefit verification, claim status analysis, and conflict resolution, fostering trust and exceptional service delivery. Previously excelled as a Customer Service Representative at Teleperformance Phils., enhancing customer satisfaction through effective communication and sales strategies. Adept at navigating technical challenges and providing comprehensive support to maximise customer engagement. Career goal: to leverage skills in account management and customer relations to drive organisational success.
1. Members' eligibility and benefits; its insurance coverage.
2. Claim status, claim appeal status, and denial reason with the explanation.
3. Prior authorisation, referral, and inpatient notification status.
4. Provider portal or web issue assistance, such as navigating the portal or web.
5. Make an outbound calls to provider an update on important matters.
6. Ensure to develop a strong relationship with the provider to create trust by providing exceptional service. be trusted with all the records and account.