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customer service contact with patients about medical needs what would help them with medical marijuana cash handlingsecurity all modules completed except for 6attention to detail, payments discounts assisting opening and closing duties help patients with payments to doh if neededTicket to Work Program through Social Security.

Serves as the first point of contact to answer questions for members, providers, brokers and potential beneficiariesExcellent customer service skills, conduct outreach phone calls for follow up calls as neededKnowledge of Medicare A, B C and D-Medicare Advantage,Knowledge of Novitas Solutions LCD policies and how to explain them to providers. Conducted multiple training classes reviewing information on the Novitas Solutions Medicare websiteCommunication with the Inside Sales/Outside Sales Representatives for smooth transition for future members Documentation and Verification on very call to ensure identity of the member is not broken Conducting phone enrollments for future members, Ability to navigate CMS MARx System to access missing information on an application or do outreach to the member Assisting members with payments, use of member portal and navigating the website for forms/documents and resources to help them with their Health InsuranceProvides problem resolution for such issues as claims, explanation of benefits, billing inquiries, eligibility and benefits, pre-authorization requirements, ID card requests and member materialsAppropriately intakes, classifies and investigates complaints and grievances for Senior Management review.Multitasking different systems to preform daily job functions Knowledge of CMS procedures- MARx, OnBase, QNXT

Verify Insurance for patients who had surgeries scheduledContacted Insurance companies for authorizations needed for proceduresKnowledge of procedure codes/ICD 10 codesCalculated quotes and educated patients on payment optionsKnowledge of Pulse System, Navinet, MCS

Admit, receive referrals and obtain Insurance verification for patients to get treatmentUnder Nursing Supervision help clean, prepare wounds for nursing and the doctor to look atScheduling appointments, communication with patients for labs, exams, x-rays and follow up appointmentsMaintained accurate records of patient care, condition, progress and concerns.

Began as a Customer Service Representative assisting providers with inquiries regarding claims and benefits, transitioned into the written inquires team where letters were written to providers for claims that could not be appealed. Then within a year promoted to a Supervisory Quality Analyst PositionAs a Quality Analyst I monitored the telephone calls for provider enrollment and the customer contact center, ensuring correct information was provided to the caller and gave corrective action when appropriate, assessed errors when incorrect information was provided and required follow up be completed to ensure the client had the correct informationKnowledge of Medicare Parts A/B, Coordination of Benefits, Medicare requirementsAnalyzed call volume and average call time to monitor Customer Service Representative performance and productivity.