Michelle P.

Background

About Michelle P.

With over 16 years of experience at Aetna, a CVS Health Company, I am a committed Senior Service Advocate focused on simplifying healthcare support for members. Specializing in claims, benefits, and regulatory compliance, I strive to provide clear and compassionate assistance across medical, pharmacy, dental, and vision services. My goal is to make each member interaction a positive, informative experience, ensuring they feel supported and confident in navigating their healthcare needs. I specialize in resolving intricate claims and benefits inquiries, assisting with prior authorizations, and ensuring compliance with state and regulatory requirements. Known for my attention to detail and empathetic approach, I focus on understanding each member’s unique needs and guiding them toward the right solutions. Core Skills: • Benefits & Claims Expertise: Proficient in analyzing and explaining member benefits across multiple service areas, from medical to pharmacy. • Regulatory Compliance: Skilled in managing complaints and appeals within regulated timelines and communicating outcomes clearly. • Collaboration & Mentorship: Experienced in working cross-functionally to resolve member issues and in supporting team members by sharing insights and best practices. • Exceptional Customer Service: Committed to providing empathetic, personalized support that ensures member satisfaction even in challenging situations. I am dedicated to improving the member experience by being a trusted advocate and am always open to connecting with professionals who share a commitment to healthcare excellence. Let’s connect to discuss ideas on enhancing service delivery and creating positive member outcomes.