Responded to members inquiries in the most efficient manner.
• Collected and documented all details of member interaction (inquiry, comments and information) into the Tufts Health operating system.
• While logged in the phone queue, demonstrated expertise of job functions by minimizing call handle times, by actively listening, and probing providers during the initial call to determine the purpose of the call.
• Professionally educated providers on Tufts Health’s policies and procedures and how to effectively interact with Network Health to optimize the member’s experience.
• Demonstrated working knowledge of all information and updates pertaining to new and/or changes to existing: products, procedures, customers, across all business lines.
• Researched and provided information regarding, but not limited to, claims/reimbursement, eligibility, benefits, provider contract status, clinical/authorization procedures, online reference materials such as provider manual and payment policies.