Customer Service Representative / Case Management Assistance
Texas Children Hospital
Houston , Usa
01 2016 - 05 2024
WORK EXPERIENCE
Texas Childrens Health Plan - Member Services
Representative / Case Management Assistant
01/2016 to 05/2024, Houston Tx
Assessed, organized and documented patient data to develop an appropriate plan of care. Instructed patients and families regarding SAl appointment, treatment plan and preventative care according to individualized health care needs. Interacted with family, disciplines regarding patient care.
- Assist with receptionist duties, file and distributed mail to multiple departments
- Inbound /Outbound call center, data entry, answer high volume of calls
- Assign correct PCP to members, market the health plan
- Assist members with bills and verify eligibility for STAR and CHIP/CHIP Perinate, Star kids
- Assist with Verification of benefits,
- Assist with Verification of in network providers; assist with claim questions and prior authorizations.
- Assist in special projects, assisted, volunteer on special events.
- Assist with Navitus pharmacy update COB and Eligibility
- Assist with training New Employees
- Assisted The Center with appointment scheduling.
- Assisted with scheduling SAl appointments for Case Management/Service Coordinador.
Handled customer complaints, providing appropriate solutions to guarantee positive outcomes.