| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Wilmington Delaware PHONE NUMBER AVAILABLEEMAIL AVAILABLE - https://LINKEDIN LINK AVAILABLE SUMMARY Formally developed and implemented Intake Forms used throughout the company and eventually. throughout the city of Philadelphia Entered data accurately and efficiently into various electronic systems Proficient in EPIC and Microsoft ApplicationsEXPERIENCEProvider Claims Service RepresentativeAmeriHealth Caritas Philadelphia, PA Call Center May 2023 - Present Entered data accurately and efficiently into various electronic systems Resolved customer issues promptly and effectively to ensure satisfaction and retention Reviews and adjudicates claims Forward claims requiring external department intervention i.e., Appeals, Disputes, TPL Investigations, Optum Pause and Cotivity Verifying Authorizations submitted through JIVA Maintains thorough knowledge of claims processing systems, and its databases and subsystems, i.e., EXP, JIVA, CORS COB LOOK-UP and SOURE HOVCustomer Support SpecialistBNY Mellon Wilmington, DE - Call Center (TEMPORARY JOB PLACEMENT SERVICE) September 2022 April 2023Provide the following services for customers who have Fidelity Debit / HSA Cards: Entered data accurately and efficiently into various electronic systems Activate / Cancel Cards, Balance Inquires, Investigate Declined Cards, and Large Purchase Advisories Lock / Unlock Cards, Order New or Renewal Cards, Order Replacement Cards Process Fraud / Dispute, Process Lost / Stolen Cards, Provide Shipping Information, Transaction Inquiries, Travel AdvisoriesInsurance Verification SpecialistWound Healing Solutions Barrington, NJDecember 2018 September 2022 Entered data accurately and efficiently into various electronic systems Verify insurances though practice management system and/or external websites(Novitasphere, NaviNet, NJ & NY Medicaid sites, Promise, Kareo and AlterPoint) Complete re-verifications monthly for recurring patients to ensure no gap in coverage. Neuropsychology CoordinatorChildren's Hospital of Philadelphia Philadelphia, PA Jul 2006 December 2018 Entered data accurately and efficiently into various electronic systems Verified and approved pre-authorizations via NaviNet and the PA Promise systems. Developed tracking forms utilizing Microsoft Applications Reviewed and approved letters of medical necessity Forwarded Psychiatric reports to families as requested by clinicians Ensured strict compliance with HIPAA regulations to safeguard patient privacy and confidentiality including processing of HIPAA Release Forms.EDUCATIONCamden County College |
