Monique

In this role, I handled a high volume of inbound member and provider calls daily, addressing inquiries related to billing, claims, and authorizations with accuracy and professionalism. I processed and submitted insurance claims, pre-authorizations, and adjustments in accordance with Aetna’s policies and federal regulations, ensuring timely and accurate reimbursement.

By maintaining a strong attention to detail and compliance standards, I helped minimize claim denials and improve billing accuracy across accounts. I also utilized Aetna’s claims management systems and CRM tools to document interactions, update patient records, and track claim progress in real time.

Represented AT&T by promoting wireless, internet, and TV services to both new and existing customers. Delivered tailored product recommendations to match customer needs and consistently closed sales that enhanced satisfaction and retention. Managed a high volume of leads through CRM platforms, accurately logging all interactions, scheduling follow-ups, and ensuring seamless communication. Regularly achieved and exceeded monthly sales quotas while maintaining top-tier quality assurance scores and upholding company service standards.

Proactively resolved 95% of customer inquiries through outbound communication via chat, phone, and email. Accurately processed payments, refunds, and account adjustments while maintaining 100% precision in documentation. Delivered prompt and effective solutions to enhance customer satisfaction, escalating complex issues when necessary to ensure timely resolution. Encouraged post-interaction feedback, resulting in a measurable increase in positive customer reviews and overall client retention. Increased customer satisfaction scores by 15% through proactive support and follow-ups