Hollis Evans

Student of Healthcare Support

• Researches inquiries by accessing the claims processing system and other informational sources
• Reviews subscribers coverage to determine type and level of benefits
• Claim status
• Check providers explanation of benefits
• Route to proper escalation department
• Troubleshoot technical issues
• Managed 30 plus incoming calls per day
• Create accurate records of every customer transaction timely and professionally
• Update providers and members information following client guidelines
• Answer denial claim questions for providers/members
• Accuracy providing patient dental history
• Will guide and or go over manual of criteria with providers/members
• CRM-MMIS live chat calls
• Schedule dentist appointments
• Create tickets for improper claims
• Informed clients of policies and procedures.
• Assisted clients in navigating the claims process, ensuring timely resolution of issues and optimal outcomes.
• De-escalated and resolved customer complaints with punctual, polite and professional service.

• Evaluate unemployment insurance claims data for potential eligibility issues
• Make outbound calls as needed to interview claimants for information verification to resolve any noted claim issues or discrepancies
• Review unemployment insurance claims for weekly benefit amounts and payments
• Process claims with confirmed eligibility issues for potential adjudication and determination by the California Employment Development Department
• Document claimant interactions, along with actions taken to supplement case notes
• Collaborate with subject matter experts to address unique issues
• Claims specialist/auditor
• CUBS
• Fact-Finding
• Benefit Audit
• ER PRO / DEF PRO
• Quality Analyst

• Faxing/filing purchase orders
• Answering phones taking messages
• Assisting other staff members, light dispatching with walkie talkie system
• Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
• Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
• Supported executive staff through scheduling meetings, coordinating travel arrangements, and preparing crucial documents. via email

• Conduct research and analysis, inspect issues, implement policies, and devise strategies
• Troubleshooting Mac pc i-phones
• Handling over 40 plus calls a day
• Reaching team goals with 95 percent or higher

• Answer telephone calls and manage outgoing call backs
• Collect payments via credit check cash set up payment arrangements
• Provided information about product and services take orders, cancel accounts
• Heavy data entry
• Notify customers of claim investigation results and any planned adjustments, submitted tickets into the system created billing invoices
• Restoring Disconnected services
• Meeting team goals per month of 85 percent or Higher

• Researching and assisting customers in troubleshooting technical issues over the phone
• Navigate through multiple computer applications with speed and accuracy
• Effectively research and identify solutions using computer-based resources
• Worked with iOS and/or mac
• Process payment via phone to restore services
• Take over 30 plus calls per day