Connie Ambalada Email & Phone Number

Benefit quotes/ medical denial appeals/ claims/ payments .

Seattle, Wa

Provide employees/group members with a responsive, consistent, hands – on approach to benefit inquiries and remove the burden of employees calls to HR dept. Supply detailed answers that resulted in – depth research, client advocacy and troubleshooting. Assist members and their families in understanding benefits. Follow up on claims/denials until resolution is reached. Assist with claims appeals if needed.

Puyallup, Wa

Research and evaluate accounts for proper reimbursement. Follow up with 3rd party payers regarding payments of claims. Document accounts for future follow up, write off, payer relations, etc. Assist management staff in evaluating and improving recovery processes and workflows as appropriate. Maintain a comprehensive knowledge and understanding of current billing/recovery requirements. Maintains access of all client’s systems, as assigned. Exceeds standard productivity and accuracy.

Tukwila, Wa

Identifies available networks in each market area and request detailed provider information from each network vendor for analysis. Matches provider against actual claims experience and produces analytic reports comparing costs and member accessibility of current network versus prospective network. Deactivation of provider numbers, effective dates, NPI related denials, NPI website, etc. Performs statistical testing of network vendor’s claimed discounts. Resolve issues related to provider or NPI numbers. Compares provider’s treatment patterns against peer group to identify providers whose cost – effectiveness varies significantly from the norm.

Seattle, Wa

Manage a book of business comprised of clients that are located both locally and nationally that are mostly self insured. Responsible for acting as the primary contact between clients and insurance carrier and retaining clients through customer service which includes open and clear communication channels with clients, producers and internal partners. Ensure accurate and timely responses occurs between all parties. Create client proposals as necessary with current and renewal details as well as marketplace options. Communicate final placement details and instructions to insurers and customers. Communicate due dates, timelines and expectation to clients and partners.

Medical Assistance Certificate Program, Allied Health And Medical Assisting Services

Studied blood drawing, injections, ECG, learned the medical instruments used by providers when giving different exams to patients. medical.

Bachelor Of Science In Accounting Undergraduate, Banking/Finance/Corporate Law