Moya

• Processed healthcare-related claims and handled member inquiries regarding benefits, eligibility, enrollment, claims status, and billing concerns via telephone and digital communication channels.

• Verified member eligibility and benefit coverage, providing detailed explanations of Medicare policies, coverage limitations, and patient financial responsibilities.

• Documented all interactions, transactions, and resolutions accurately within CRM and claims systems to ensure proper follow-up and compliance.

• Utilized multiple systems simultaneously, including CRM platforms, claims databases, benefits systems, and billing tools, to efficiently service members in a structured environment.

• Delivered technical support for web-based and mobile applications while maintaining strict confidentiality of protected health information (PHI).

• Managed e-commerce support tickets through platforms like Zendesk, Shopify, and Gorgias.

• Resolved order-related issues, refunds, cancellations, and product inquiries.

• Maintained customer satisfaction by providing timely and accurate resolutions.

• Used pre-scripted responses and personalized communication to enhance customer experience.

• Collaborated with internal teams to escalate and resolve complex cases.