Ana Ortega

Took 60-75 chats daily. Assisted customers in making payments. Answer general billing questions. Gave detailed breakdown of invoice. Guided customers with online accesses. Conducted troubleshooting to resolve technical issues. Submitted tickets and followed up with customers.

• Took Calls from doctor's offices, pharmacies and members to review pharmacy insurance benefits. Gave quotes for medication coverage. Created and reviewed documents for Prior Authorizations according to Plan Contracts.

• Guided members through survey to find any needs for community based support. Provided members with referrals to a variety of organizations to meet their needs. Answered customers questions. Followed up with members to properly document success stories.

• Real time management of 75-100 clinical and non-clinical staff. Made real time adjustments to scheduling and staffing to meet contractual goals. Completed quality audits on staff. Identified any trends for error and adjusted systems accordingly. Conducted interviews for potential staff. Took escalated calls.

• Answered clinical calls and appropriately routed calls to clinical staff. Created triage charts for clinical staff based of members symptoms. Asked probing questions to elaborate on symptoms. Answered general questions regarding health plan and covered locations.

• Spoke to callers in federal default for student loans. Gathered demographic and financial information. Determined best payment arrangements to meet callers financial situation. De-escalated irate callers. Reviewed garnishment process. Gathered and reviewed all relevant documents.