Andrea Moses Email and Phone Number

Researched specific product reimbursement to high-level third-party payer contacts on behalf of over 500 different medical providers when restrictions were in place and/or denials for coverage that resulted in coverage for the product.Conducted escalated insurance coverage verification via telephone, completed prior authorizations and claim appeals, as needed resolving in coverage for therapy for the patient. Received escalated helpline calls from difficult callers, unique situations and/ or calls needing special customer handling with an ending result of 98% customer satisfaction. Conducted daily Quality Check analysis of data entered into the database to ensure all data was completed and accurate in order to provide accurate reports to clients. Adhered to SOPs and metrics with regard to all work performed.Completed client’s requests assigned by Manager.Identified, assessed and resolved complexed issues, technical issues and process issues along with Program Manager.Maintained comprehensive resource files on programs and products.Prepared reports regarding the program work such as phone reports, database reports, draft client reports, etc.Perform other tasks assigned by management such as providing assistance to other programs to help meet contracted timelines. Coordinated task assignments for team members across multiple programs and teams, ensuring all tasks are completed and deadlines are met at close of business of each day.Developed a model to properly track materials required to complete a 5,000 piece quarterly patient program mailing.

Contacted insurance companies and obtained benefit information, eligibility, submitted claims and confirmed payment status.Created or updated patient files when scheduling CAT and MRI scans; posted procedures and payments; answered telephone; light clerical duties.

Scheduled and coordinated patient surgeries, pre-operative testing, appointments and referrals.Answered telephone and handled messages; various general office procedures including receiving and returning film and orders for surgery.