Crystal Orosco

Performed Medicare and Medicaid verifications and eligibility checks utilizing MARX and MELA systems. Utilized state portals, reference guides, and various resources to accurately determine Medicaid eligibility for specific states including OH, CA, and FL.

Served as a primary point of contact for agent inquiries, providing timely support and assistance via phone and email. Ensured the smooth progression of applications and beneficiary enrollments by maintaining clear communication with agents and carriers. Monitored and tracked contract statuses, verifying compliance with key requirements for Medicare Advantage and other Medicare product sales.

Researched and presented findings for grievances and appeals from recordings and enrollment systems within specified timeframes. Processed applications by verifying accuracy of contracts, demographics, and quote details. Conducted outbound calls to gather missing information from customers and potential clients, documenting each issue from start to finish.

Handled inbound and outbound calls, transferring them to appropriate departments based on caller needs. Created new files for prospect callers and updated existing member files. Completed customer enrollments for PDP and MA/MAPD plans.

Completed a comprehensive program in Medical Billing and Coding, gaining expertise in healthcare administrative processes. Acquired skills in medical terminology, coding systems, and insurance claim processing.