Ceili Tyrrell Email & Phone Number

New York, United States

Irving, Texas, United States

- Run eligibility test files through mapping software, validate input/output test cases and deliver test results to clients for pre-production approval.- Act as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols for both Commercial and Employer Group Waiver Plan (EGWP) - Part D clients.- Researching, processing, and formulating solutions for routine and complex Medicare enrollment issues. - Support client implementation… Show more - Run eligibility test files through mapping software, validate input/output test cases and deliver test results to clients for pre-production approval.- Act as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols for both Commercial and Employer Group Waiver Plan (EGWP) - Part D clients.- Researching, processing, and formulating solutions for routine and complex Medicare enrollment issues. - Support client implementation timelines and project plans within department expectations to execute timely and successful deployment efforts. - Monitor enrollment processes across multiple systems/processes. Facilitate and document internal and external meetings along with presenting status updates and make decisions relative to client projects and implementations. - Establish and manage Annual Enrollment Period (AEP) project plans to ensure proper tracking and timely action to intake and deploy enrollment files, member moves/terminations, PBP, and account structure changes. Show less

Irving, Tx

- Lead and perform activities related to servicing clients with immediate resolution of client inquiries.- Analyze reports and communicate results to clients - Act as 1st level of escalation for the Enrollment Consultant levels to assist with guidance, client issues, questions, inquiries and/or escalations.- Facilitate EGWP Operations AEP touchpoint calls to review file tracking document for client’s file status with internal partners

Irving, Texas, United States

- Scheduled patient surgeries, including preparing and ensuring that all necessary paper work is complete; verifying insurance and/or ensuring that financial arrangements are in place to pay for said surgery; and arrange and coordinate pre-testing and surgical dates.- Maintained patient care database by executing ongoing true-up data files, verifying mismatches reports and backing up patient data.- Performed financial transactions and related functions when appropriate and directed by… Show more - Scheduled patient surgeries, including preparing and ensuring that all necessary paper work is complete; verifying insurance and/or ensuring that financial arrangements are in place to pay for said surgery; and arrange and coordinate pre-testing and surgical dates.- Maintained patient care database by executing ongoing true-up data files, verifying mismatches reports and backing up patient data.- Performed financial transactions and related functions when appropriate and directed by physician or office manager.- Researched and reviewed information to determine validity of insurance claims and contact companies and customers about medical necessity decisions.- Validated patient and medical provider demographic information including a correct selection of a medical provider by specialty for health care services.- Educated patients via web tools; explained Care Plans; initiated the Care Plan; provided educational information in conjunction with direct care providers related to treatments, procedures, medications and continued care requirements. Show less

Business Administration And Management, General

Associate'S Degree, Pre-Nursing Studies