Experienced Advanced Care Specialist that is detail-oriented and results-driven. Extensive experience in managing high-volume customer interactions and providing exceptional care in fast-paced environments. Adept at processing insurance claims, verifying patient information, and navigating complex healthcare systems, including medical billing, coding (ICD-10, CPT, HCPCS), and claims denial management. Skilled in ensuring compliance with HIPAA regulations and healthcare industry standards, while delivering accurate and timely solutions. Proven track record of successfully de-escalating challenging situations, advocating for patient needs, and collaborating with insurance providers to resolve issues efficiently. Strong technical skills in claims management software and EHR systems, with a commitment to maximizing claims accuracy and optimizing patient outcomes. Ready to contribute exceptional customer service, problem-solving abilities, and healthcare claims expertise to drive the success of a Health Claims Specialist team.
· Coordinated and scheduled on-site visits for system installations, repairs, and routine maintenance based on customer availability and technician schedules.
· Managed reschedules and cancellations promptly, offering alternative appointment times to ensure customer satisfaction.
· Updated and maintained accurate customer and service records in scheduling systems. Ensured that all service calls are completed within the designated time frame to meet company standards.
· Responded to customer inquiries via phone, email, and chat regarding product details, order status, and delivery information.
· Managed and de-escalated customer complaints professionally, ensuring that customer concerns are addressed with empathy and efficiency.
· Resolved account-related issues, such as billing discrepancies, order status, and delivery problems.
· Performed routine inspections, preventative maintenance, and troubleshooting of machinery to ensure compliance with safety and operational standards.
· Maintained accurate and up-to-date records of system operations, maintenance, and repairs, ensuring full compliance with industry regulations.
· Worked closely with engineering, operations, and safety teams to address technical issues, improve system performance, and enhance operational efficiency.
· Managed a team of QA technicians, providing guidance, training, and performance evaluations to ensure high-quality product standards.
· Conducted routine inspections of production lines, including raw materials, in-process products, and finished goods, ensuring adherence to safety, quality, and food safety standards.
· Ensured compliance with USDA, FDA, and other regulatory agencies’ guidelines for food safety and quality.