Salome Micheal

Member Engagement Specialist @Avmed

US

Used Salesforce tools to deliver exceptional service experience by collaborating with internal teams to resolve issues and escalated cases to appropriate de-partments in a timely manner. • Managed requests for about 1,500+ customers on the Salesforce platform. • Responsible for providing high-quality level of customer service to plan members by answering complex benefit questions. • Resolving issues and educating members in a continuous call volume atmosphere. • Coordinate intake of grievances and appeals as necessary ensuring that all concerns are responded to and resolved appropriately with first call resolution whenever possible. • Worked closely with cross functional teams to onboard over 2500+ new customers onto the Salesforce platform. • Strong analytical problem-solving skills Excellent written and verbal com-munication skills Self-starter takes the initiative and works well under pres-sure • Maintain confidentiality according to Member Engagement Representative regulatory requirements. • Maintain strong knowledge of benefits, claims, appeals, grievances, and Medicare regulatory requirements. • Use HRP, CRM, Acuity, Citric to verify claims & premium payment • Use Acuity NovoLog & Evicore software to verify Authorization • Use Service Now to create a Ticket to be escalated to IT Dept • Experience in CPT, ICD-9, ICD-10, HCPCS coding and HCC Coding verification. • Constant Contact and Convas to create Companies NewsLetters.

Lagos State University

Bachelor of Science (B.Sc.), Accounting

Florida International University

Master's Degree, International Business(MIB)