Personal Health Coordinator: Benefits
Cincinnati, Ohio, United States
- Conducted outreach, processed medical and pharmacy claims, and managed care for 415 high-risk members, significantly improving health outcomes.
- Assisted with closing HEDIS gaps, contributing to a 15% improvement in compliance rates and overall member health.
- Thoroughly examined claims and tracked information for reporting and data analysis, ensuring 100% accuracy in claim processing.
- Assessed daily activities, cognitive, behavioral, and social support needs of members, making over 300 referrals to appropriate departments or facilities.
- Verified member eligibility and benefit coverage, guiding members through open enrollment processes and increasing enrollment rates by 20%.