Darrice Dean Email & Phone Number

Research claims forwarded to Workers Compensation, determines appropriate action based on knowledge of medical coding and criteria for potential workers compensation involvement. responsible for helping to determine new methodologies to ensure we obtain the correct information. Establishes and maintains case files in both the workers compensation database and excel. Respond to correspondence from the group representatives and adjusts claims if necessary, performs requisite file maintenance, lead monthly team meetings to go over goals and new processes within the organization.

Review routine moderately complex refunds, and return checks to determine the reason for refund.Identify the appropriate claims to allocate and make adjustments to and analyze outstanding invoicetrends. Research issues with contracting and pricing, coordination of benefits, Medicare and Medicaid overpayments, account receivable balances; validate if adjustments were done correctly.coordinate team meetings to discuss more effective ways to process the refunds and possible trends that we see from the group and providers.

Provide outstanding service, create peace of mind to identify and resolve customer inquiries and concerns about health insurance coverage and claims, provide written communications to both members andproviders, strong knowledge of multiple systems used on an everyday basis, efficiently navigate the system to find the correct answers and communicate with clarity and empathy to provide an excellent customer service experience.

Twinsburg, Oh

Obtaining updated insurance information for patients, collecting and calculating all accumulations for insurance premiums on the highest priced items the company handles,verifying diagnosis codes and claim estimations, assist with training new hires

Bachelor’S Degree, Health/Health Care Administration/Management, 3.5

Associate’S Degree, Liberal Arts And Sciences, General Studies And Humanities