Brandy Jefferson Email & Phone Number

Monroeville, Pa, Us

United States

Medical Collections: Utilize A/R reports from SoftAid and identify accounts that are past timely payment. Make contact with insurance company, vendor and patient to learn status of payment. Medical Billing: Re-bill claims that are lost by insurance company/vendor and provide substantiating documentation if necessary.Documentation: Obtain necessary documentation (updated medical order, clinical notes, patient agreement, etc.) and submit to insurance carrier to affect payment of claim.

Greater Pittsburgh Area

Work via an auto dialer, contact newly enrolled members to welcome them to the health plans. To develop a positive relationship and ensure the member has the information and documentation they need. Use of talking points to welcome the member to their respective health plan by verifying and or editing key information about the member (home address, PCP assignment, etc.) and discussing the benefits available through the plan. Encourage members to appropriately utilize services in an effort to improve the health and well-being of all members. This might include education about the importance of prenatal care or childhood immunizations and the importance of using the ER only in true emergencies. Complete a Health Risk Assessment following the United Healthcare national standard HRA as programmed into the Care One system. Order member materials transfer the member to appropriate member services or care management as needed. Document member responses and call outcomes in the databases as appropriate. Assist with projects and/or assignments designated by the Supervisor or Manager. Assist Supervisor with orientation/training of new employees as assigned. Actively participate in departmental quality improvement monitoring and other activities to promote the delivery of high quality services to all customers. Provide input into the development of policies and procedures that affect the program or department. Give input into improving member education strategies and materials.

Greater Pittsburgh Area

Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. May seek assistance with complex customer services issues. Trained incoming reps on systems.

Perform accurate and timely processing of enrollment and disenrollment elections in compliance with federal regulations. Perform telephonic outreach to Medicare members. Maintain or exceed department standards for call volume, response time and related production and quality measures. Track and route member medical bills received while the member was enrolled on Gateway. Interact with external entities including, but not limited to Medicare call center personnel, Department of Public Welfare County Assistance Office personnel, members and member representatives

Greater Pittsburgh Area

Answered incoming calls from health system members who wanted to upgrade their healthcare coverage.

Greater Pittsburgh Area

Answer telephones, directing calls to patients and staff members, placing doctor’s orders into computer using the Citrix Meta Frame system, creating patients’ chart upon admittance and discharge, breaking down patients’ medical charts upon discharge and placing the chart with Medical Records, and ordering supplies for entire unit using the PeopleSoft Purchasing system. Assist patients in their daily living/occupational routines. Check routine vital signs. Perform Accu-Check readings for patients with diabetes. Phlebotomy draws. Assist with meal times.

Education record

Education record