Highly motivated, very strong willed and driven. Technically-savvy with outstanding relationship building, training and presentation skills. Excellent at juggling multiple tasks and working under pressure. Multiple areas of expertise.
Professionally handle incoming telephone calls from Internal and External customers
Explain EOB's (Explanation of Benefits) to members based on questions asked
Posted payments to member accounts from statements received
Enter telephone inquiry report of contact into customer service intake screen
Maintain telephone performance goals established by the specified division
Manage personal route list daily
Provide the same high quality service to “walk-in” inquiries that is provided for telephone inquiries
Work with all departments in the division or company to resolve customer service inquiry issues
Attend available training sessions to further enhance skills
Ensure timely and accurate completion of daily/weekly telephone reports
Stay up-to-date regarding online resources, such as Online Help, BlueAlert, Medical Policy, and all other electronic resource changes when applicable
Processed claims
Receive and direct all incoming calls to the appropriate party, in a timely and professional manner.
Interview patients at workstation or at bedside to obtain all necessary account information. Bed-side
registration performed utilizing carts/computers on wheels
Coordinates with business office meal ticket monies, safe entries and removals, mail distribution, and
vehicle sign ins/outs.
Calculate and collect patient liability amounts
Verify insurance benefits and determines pre-certification/authorization status via on-line or other
resources. If pre-certification/authorization/notification of admission is required and has not been
obtained, initiate via Passport, on-line or phone call. - Enter all information and authorization/referral
numbers into the registration system
Interview incoming patients, his/her relatives, or other responsible individuals to obtain identifying and
demographical information with insurance and financial information
Assign Insurance Plans (IPlans) accurately
Search MPI completely and assign the correct medical record number. Notify HIM for any duplicate unit
numbers
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