Michael Justice
Utilization Review Specialists at Umpqua Health- Claim this Profile
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Bio
Experience
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Umpqua Health
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United States
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Hospitals and Health Care
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1 - 100 Employee
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Utilization Review Specialists
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Apr 2018 - Present
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Appointment Center Representative
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Aug 2017 - Feb 2018
Took incoming calls to schedule sales appointments for System Design Specialist. Entered accurate customer profile information. Made outbound calls to follow up on hard to reach customers. Worked the department email box for any customer request. Followed up on an issues. Manually mailed letter and brochures to potential customers.
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Enrollment Specialist
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Apr 2015 - Aug 2017
Started out in customer service. Took incoming calls from current members in regards to plan benefits, co-pays, prior authorizations, medication information and more. After a year I was promoted to the enrollment department. Was then promoted to the lead for all commercial/group Affordable Care Act plans. Was responsible for entering all applications with accurate profile information. Also, maintained plans and updated with any changes in plan rates, number of members on the plan and an additions to the plan. Made executive decisions to disenroll a member if and when appropriate. Created and implemented processes to streamline the enrollment process for commercial members. Also, entered Medicare applications for eligible Medicare members. Created reports for manager review to show number of members, number of dis-enrolled, reasons why, and any software anomalies.
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Co-Owner
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Aug 2007 - Apr 2015
Obtained contracts for residential and commercial properties. Cleaned inside of residential and commercial properties. Responsible for quality control and invoicing clients. Maintained schedules to ensure completion of jobs in a timely manner.
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Dell Technologies
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United States
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IT Services and IT Consulting
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700 & Above Employee
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Account Executive
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Dec 2004 - Aug 2007
Took inbound sales calls in a call center environment. Helped potential customers design and purchase computer systems. Maintained accurate customer profile information. Assisted in department meetings with new ideas to help increase sales stats.
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Education
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Cleveland Institute of Electronics
Associate's Degree, Computer Software Engineering -
Old Dominion University
Bachelor of Science - BS, Information Technology