Keyane Woodruff

Assisted customers with inquiries regarding health insurance plans and benefits.

• Managed customer accounts, updating personal information and processing changes to ensure accuracy and compliance.
• Facilitated communication between members and healthcare providers, streamlining claims resolution for improved customer satisfaction.
• Educated customers on policy details, coverage options, and claims procedures.
• Resolved customer inquiries and concerns, delivering quality service while consistently meeting performance benchmarks.
• Communicated with healthcare providers to verify insurance eligibility and benefits.
• Checked CPT/HCPCS and ICD-10 codes for coverage, benefits, and preauthorization requirements.

• Processed claims using company-specific software systems, ensuring timely and accurate resolution.
• Evaluated claims to determine eligibility based on established criteria.
• Collaborated with team members to resolve complex claim issues, enhancing overall team effectiveness.
• Processed a high volume of incoming claims in accordance with established policies and procedures.
• Verified claim data correctness in preparation for processing.
• Analyzed contracts and claim systems to apply appropriate benefit amounts.
• Managed workload to consistently meet productivity and quality standards, contributing to team success.

• Maintained accurate client records and updated policy information to ensure compliance and enhance client satisfaction.
• Provided ongoing support and advice to clients on policy adjustments, fostering long-term client relationships.
• Offered policy guidance and management to help clients effectively protect their assets.
• Assisted clients in understanding life insurance options and policy details.
• Educated clients about the benefits of life insurance products.