JASMINE DYER
Port Wentworth
Summary
Detail-oriented Navigator with a strong background in managing healthcare inquiries and ensuring HIPAA compliance. Skilled in conflict resolution and streamlining processes to improve customer satisfaction and operational efficiency.
Overview
1
1
year of professional experience
Work History
Navigator
TriWest Healthcare Alliance
Port Wentworth, GA
11.2024 - Current
- Managing live chat, email, or messenger-based communication regarding plan benefits, claims status, billing issues, and eligibility.
- Assisted in navigating healthcare options for members, ensuring understanding of benefits and services.
- Engaged with multidisciplinary teams to streamline communication and resolve patient inquiries effectively.
- Ensuring all chat interactions protect Patient Health Information (PHI) and strictly follow HIPAA privacy regulations
- Educated clients on policy details, enhancing their decision-making process.
- Improved customer satisfaction by efficiently addressing and resolving health insurance inquiries.
- Handled inquiries and resolved issues, maintaining high customer satisfaction levels.
- Monitors and manages chat queues, providing real-time assistance to frontline Customer Service Representatives (CSRs) to ensure high-quality service.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Coordinated with healthcare providers to verify coverage and eligibility.
- Collaborated with team members to streamline claim processing procedures.
- Adapted quickly to changes in policies and regulations, ensuring compliance across operations.
- Collaborated with healthcare providers to ensure accurate billing practices, reducing disputes and errors.
- Manage assigned case loads daily, ensuring timely resolution and documentation
- Update medical authorizations, CPT codes
- Investigate and reprocess cases as needed to ensure proper claim handling
- Provided training support to new hires on company policies and service protocols.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
Education
High School Diploma -
Bluffton High School
Bluffton, SC06-2011
Skills
- Child CPR and first aid
- CPR certified
- Complaint handling
- Conflict resolution
Certified Phlebotomist
- Customer relations
- Follow-up skills
- De-escalation techniques
- Technical support
Timeline
Navigator
TriWest Healthcare Alliance
11.2024 - Current
High School Diploma -
Bluffton High School
phlebotomist
I have been a certified phlebotomist since 2020, with experience working with Beaufort Memorial Hospital.