Eunice Sintos

Handle a high volume of incoming phone calls from customers and healthcare providers regarding prior authorization requests. Verify and gather all necessary information to process prior authorization requests accurately and efficiently. Assess and evaluate customer needs, providing appropriate guidance, and answering inquiries about prior authorizations. Collaborate with internal departments to ensure a smooth and timely authorization process. Document all customer interactions and maintain accurate records of prior authorization requests, updates, and resolutions. Assist customers with questions related to claims, benefits, and coverage, providing clear and concise explanations. Perform general administrative duties, including data entry, filing, scanning, and maintaining documents. Utilize Microsoft Office tools (e.g., Word, Excel, Outlook) to create and update reports, spreadsheets, and other relevant documents. Stay up-to-date with company policies, procedures, and guidelines to provide accurate and current information to customers. Identify and escalate complex or unresolved customer issues to the appropriate department or supervisor.