Chamica Mcgruder

Respond to high-volume member calls about benefits, eligibility, and claims, educating members on coverage, preventive care, prescriptions, and cost-sharing. Verify eligibility and update account information while collaborating with internal teams to resolve complex concerns with HIPAA-compliant, empathetic support.

Provide callers with Medicaid and Medicare eligibility information, including renewals and coverage options. Verify eligibility status and support vulnerable populations with clear, compassionate communication to ensure access to care.

Coordinate patient scheduling by handling calls for appointments, rescheduling, and cancellations while assisting with insurance eligibility and benefit questions. Clarify billing statements, co-pays, and out-of-pocket expenses and process medication refill requests, improving scheduling efficiency through streamlined intake and follow-up.

Handle inbound claims inquiries via calls, email, and chat, resolving questions, complaints, and claim processing discrepancies. Verify claims accuracy and collaborate with providers to fix issues while maintaining high accuracy and meeting remote call metrics.

Support delivery partners and customers through live chat, email, and phone by troubleshooting delivery issues and driving timely resolutions. Onboard new delivery partners with documentation and training while building rapport through empathetic, responsive communication.

Attended Plainfield High School in Plainfield, Illinois.