Customer Associate Expert

working as customer support for both providers and members

were able to communicate effectively to a diverse individual

Verified professional licenses, certifications, and educational credentials of healthcare providers Maintained up-to-date provider profiles in credentialing databases Ensured providers meet insurance, regulatory, and organizational compliance requirements

Extensive experience managing healthcare tasks including medical billing, insurance verification, denial management, and patient advocacy. Demonstrates strong problem-solving skills, compliance expertise, and the ability to handle high-volume, high-pressure environments while maintaining quality and professionalism.

Familiar with medical terminology, procedures, and diagnostic codes (ICD, CPT, HCPCS) Assisted in explaining treatment plans, procedures, and benefits to patients Reviewed medical records, claims, and provider documentation for accuracy Understood insurance coverage, benefits, and limitations to guide patients and providers

Ensured confidentiality of patient information in all communications, both written and digital Handled medical records, claims, and benefit information according to HIPAA regulations Maintained secure documentation systems to protect sensitive health information

Reviewed and analyzed denied or rejected claims to identify the reason for denial Communicated with insurance providers to resolve claim issues or discrepancies