priya

In the Customer Service industry, with a focus on healthcare support during my time at Sagility. In my role, I was responsible for educating healthcare providers on the benefits patients were entitled to under their medical insurance plans. I clearly explained covered services, verified procedure codes for preauthorization requirements, and provided updates on both predetermined and preauthorization statues. I supported inquiries related to claims and pharmacy benefits, ensuring patients and providers had accurate and timely information. I also assisted patients and new leads in locating in-network and out-of-network providers, helping them access affordable care while maximizing insurance coverage.

I provided courteous and prompt resolution to provider/member inquiries by conducting thorough investigations and fully educating provider/member with the goal of resolution on initial contact. I led root cause analysis of service failures, presenting insights to leadership and recommending strategies that enhanced service recovery and customer loyalty