Hi! I'm Bhill Mark Harold Bombase, a Quality Assurance Auditor and Customer Service Professional with over 3+ years of experience in healthcare support, claims processing, and performance quality analysis for global companies such as Optum, Aetna, and WNS.
I help businesses improve customer experience, agent performance, and operational efficiency through data-driven evaluations, clear feedback, and process optimization.
What I Can Do for Your Business:
1. Quality Assurance & Auditing
Evaluate calls, chats, and emails using quality scorecards.
Identify performance gaps and coaching opportunities.
Ensure compliance with SOPs, policies, and client standards.
Provide detailed QA reports and actionable insights.
2. Customer Service & Support
Handle inquiries for eligibility, benefits, billing, and claims.
Resolve disputes with accuracy and empathy.
Navigate complex medical records and documentation confidently.
Maintain high CSAT and quality scores.
3. Claims & Healthcare Operations
Claims status reviews, reprocessing, and dispute resolution.
Medical, dental, vision, and worker?s compensation claims.
Understanding of CPT/procedure codes and state rules.
Strong attention to accuracy and compliance.
4. Process Improvement & Analytics
Identify workflow inefficiencies and improvement areas.
Use data and QA trends to drive performance improvements.
Skilled in documentation, reporting, and root?cause analysis.
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