Emma Goodman

Led the customer service department through the transition to Astrana Health, supporting policy alignment, operational changes, and employee training. Coordinated health plan and regulatory audits, managed grievances and escalations, maintained policies and procedures, and reported weekly/monthly KPIs.

Coached and trained customer service agents while supporting audits, escalations, grievances, and department training materials. Monitored call quality for 30–40 agents monthly with detailed written reports and supported new-hire and refresher training.

Handled escalated calls and managed department inboxes within turnaround time requirements. Supported quality and training functions, including assisting with monthly quality score processing and helping draft responses to health plan grievances as needed.

Provided inbound customer service while meeting daily call goals and ensuring pending escalations were followed through. Coordinated with internal departments (UM, Claims, Eligibility, Compliance) to resolve issues accurately and ensured policy/procedure compliance on all calls.

Answered inbound calls for eligibility, benefits, claims, and referrals inquiries and provided accurate benefit breakdowns to providers and members. Filed grievances on behalf of members in accordance with compliance and state regulations.

Conducted outbound calls to assigned leads and scheduled preventative health appointments with members. Followed phone etiquette and script protocol and used an efficient route approach for traveling providers.

Called patients to refill prescriptions and answered incoming calls from providers and patients to assist with inquiries. Managed paper filing, completed order forms with payment and shipment details, met team goals, and trained new employees.

Supported pharmacy operations by handling inbound calls from providers and patients and assisting at the drop-off counter. Filled prescription orders, restocked medication shelves and automated machines, and assisted the pharmacist as needed.

Completed Pharmacy Technician technical training at Downey Adult School in 2014.

Attended Golden Valley Charter School in Ventura, California in 2013.