Dance Jam & Barbell Strength Instructor

(Formerly Equian) * Tracking of daily cases, monitoring status of payment, setting projections, updating file, calling contacts on file, evaluating injuries, review of claims and setting out diary for appropriate follow up. * Missing claim searches through Molina database access. For myself and my teammates.* Tracking payments received, setting refund tasks when necessary on over payments. Working with our finance department in locating missing checks or when payment was received but check was incorrect. * Calling attorneys and adjusters to get funds transferred in a timely manner and setting short follow up. * Maintain one of the highest inventories for my team. While staying current. * Having the highest goal for my team as a recovery specialist and being able to meet/exceed maximum recoveries consecutive months in a row. * Review and respond so subpoena requests.* Knowing the Medicaid/Medicare law and be able to explain that when trying to receive payments on liens.* Understanding State laws and knowing the reductions allowed by statute of each state. Mainly: MI, FL, CA, WA, TX, SC. * Responsible in also knowing rights for subrogation on commercial bases plans.* Professionalism in dealing with attorneys offices and adjusters.* Handle most cases related to auto accidents, property/premises cases, assault/restitution and medical malpractice. * Knowing state auto benefits for MED PAY/PIP as well as the handling of BI/LIABILITY settlements.* Understand Statute it Limitations by state. * Take on various other projects as needed to maximize recoveries.* Investigate daily new files for sources of recovery along with data entry.* Train new employees * Take on extra file loads when necessary.* Work with our sales department in order to get legal language from the plan. * Update all files as electronic correspondence come in daily.

Position Summary:Use design skills and product knowledge to assist consumers, contractors, and designers in selecting products with their tile projects in order to achieve desired design objectives. Essential Functions:• Actively listen to customers to understand needs and present products that are consistent with customer needs and preferences• Provide recommendations to meet space, style, and cost requirements• Deliver exceptional customer service by exceeding customer expectations• Continually update and maintain knowledge of products including porcelain tile, natural stone, glass and Artisan Ceramics• Maintain and merchandise the appearance of the showroom by keeping showroom displays visually exciting and enticing• Maintain knowledge of competitors and their products• Maintain literature, price lists, samples, supplies and display boards

• Conduct inbound/outbound telephonic contact with members in a professional manner and maintain phone stats according to departmental goals• Educate members and providers on members benefits, rights and responsibilities • Educate members and providers on Meridian Health Plan (MHP) policies and procedures regarding access to care, grievance and appeal process and eligibility process• Consistently demonstrates compliance with HIPAA regulations, professional conduct and ethical practice• Provide “CMC Factor” customer service to members, providers, and internally to all Caidan Management Staff • Act as a liaison between providers and members on all issues• Remain updated on all member and provider policy changes made by MHP or the State • Welcome new members to MHP monthly and ascertain member medical needs to ensure a smooth transition to the MHP network• Performs accurate data entry into MHP systems and software programs• Understand and be able to maneuver through the MHP member handbook• Work with transportation and PCP office to schedule members’ appointments as needed• Make appropriate referrals to other departments when necessary• Assist members through Live Chat• Process Member Data Changes, State File Changes, and Member Services Faxes in a timely fashion • Perform other duties as assigned

Daily operation of the five doctor practice to include opening and closing, new patient demographics, verification of all insurance, billing inquiries, phone coverage, calling in prescriptions, taking patient vitals, sending patient mail-outs, filing and scheduling new patient appointments.

Responsible for project management, preparing proposal packages, floor plan and purchase order audits, selecting finishes and fabrics, event planning, design fabric and finish boards, floor plan creation, and advised client on interior design factors such as space planning, layout and utilization of furnishings or equipment, and color coordination; presented final design to client for approval.

Purchased furnishings and accessories for designers, price book changes, art work decoration, display changes, organizing fabrics.