Determined Academic Advisor accomplished at ensuring students meet educational requirements and talented at advising students on degree-specific programs. A superior grasp of academic advising principles. Strong communication and interpersonal abilities, with ability to negotiate, provide conflict resolution, and strategic decision-making.
· Specialized in the operations department by doing comprehensive claims management, provide a global medical network for patients, and communicate with providers/physicians to ensure customer satisfaction for members who travel overseas under the BlueCard Worldwide and Federal Employee Program..
· Case Manager for international medical cases, by accurately in-taking information, providing member with process of medical case management.
· Reviewed documents in order to approve benefits for member outpatient or inpatient services to send to providers.
· Data analysis and critical thinking skills required to act in a fast an efficient way to deliver proper information in a professional manner to Blue Cross Blue Shield members, representatives from Blue Cross Blue Shield, Federal Employees, and health providers.
· Identified and resolved problems in a timely manner, individually and in a group setting by using reason and logic.
· Listened to member's needs, and providing them assistance so that they experience customer satisfaction, by using empathy, understanding their perspective, and offer a solution for them.
· Worked closely with colleagues and management by creating an efficient communication strategy when dealing with other departments in the company, as well as train new employees on case and claim management process, procedures, data analysis, documentation, and communication skills.
· Escalated matters to proper department in order to get documents accessed and processed for member's medical claims, and medical cases.
· Communicate my ideas effectively in order to provide a better perspective on situations that need improvement on current procedures and/or future procedures.
· Handled monthly reports on case services fees, and case reviews to properly close cases.
· Handled medical translation request by creating administrative cases, set up tasks for translators, and track all completed translations for client.
· Reviewed benefit letters that are to be distributed to providers in order to guarantee outpatient and inpatient services.
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