Home health LPN pediactic & Welllnet healthcare

• Jun 2021 - Present

Medical Billing Specialist

• Jan 2016 - Present

Click to edit position descriptionSpecialist – Call Center who will be responsible for providing telephonic support to customers inquiring about an outstanding debt to Medicare. Additionally, there is significant interaction with insurance companies (Group Health Plans) that are identified as being a primary payer to Medicare. To that end, Medicare Secondary Payer (MSP) Specialist – Call Center will be responsible for the following: • Under direct supervision, handle incoming calls and mail from employers and Group Health Plans appealing Medicare's assertion of improper coordination of benefits • Use analytical/critical thinking skills to determine the nature of phone calls, appeals, and correspondence by employers and Group Health Plans; follow Standard Operating Procedures (SOPs) to achieve call/case resolution • Initiate a demand process with insurance companies including evaluation of beneficiary information and coordination of benefit information • Track correspondence through the demand process to ensure a timely response within service level agreements • Facilitate and document communication with insurers and employer groups • Provide accurate and timely responses to queries • Escalate queries that are not routine or have special circumstances to supervisors in alignment with prescribed processes Show less

Sr. Medicare Specialist Call Center

• Oct 2011 - Feb 2012

Specialist – Call Center who will be responsible for providing telephonic support to customers inquiring about an outstanding debt to Medicare. Additionally, there is significant interaction with insurance companies (Group Health Plans) that are identified as being a primary payer to Medicare. To that end, Medicare Secondary Payer (MSP) Specialist – Call Center will be responsible for the following: • Under direct supervision, handle incoming calls and mail from employers and Group Health Plans appealing Medicare's assertion of improper coordination of benefits • Use analytical/critical thinking skills to determine the nature of phone calls, appeals, and correspondence by employers and Group Health Plans; follow Standard Operating Procedures (SOPs) to achieve call/case resolution • Initiate a demand process with insurance companies including evaluation of beneficiary information and coordination of benefit information • Track correspondence through the demand process to ensure a timely response within service level agreements • Facilitate and document communication with insurers and employer groups • Provide accurate and timely responses to queries • Escalate queries that are not routine or have special circumstances to supervisors in alignment with prescribed processes Show less

Customer Service Representative

• Sep 2010 - Aug 2011

Consultant Support Representative Responsible for Building the Consultant Experience. Under limited supervision, deliver effective execution of service and marketing strategies, and provide administrative support to consultants. No direct reports. Reports to Supervisor, Consultant Support. Must possess the ability to: * Deliver consistently excellent customer service over the phone and in writing * Support consultants through back-office administration, client administration, and marketing support * Document all interactions with customers and prospects to improve internal communication and program execution * Navigate multiple systems and apply customer service and direct sales expertise in order to provide accurate and timely delivery of Thirty-One products * Consistently meet established standards for productivity and quality in inbound, outbound, email, and returns support Show less