Derek Doherty Email & Phone Number

United States

- More to come- Worked with my partner and Manager as the "RAR Team".- The RAR Team was created to overhaul and completely document the complex process of submitting Retroactive Adjustment Requests (RARs) to Medicare for review.- This involves finding plan errors, member errors, Medicare/Social Security errors and having plan systems and the Medicare.

Watertown, Massachusetts

- Worked with my partner and Manager as the "RAR Team".- The RAR Team was created to overhaul and completely document the complex process of submitting Retroactive Adjustment Requests (RARs) to Medicare for review.- This involves finding plan errors, member errors, Medicare/Social Security errors and having plan systems and the Medicare Database (MARx).

Watertown, Massachusetts

- Research and resolve multiple types of rejections on the Daily Transaction Reply Report received from CMS (Centers for Medicare and Medicaid Services). This requires knowledge of both Medicare and Medicaid guidelines as well as internal system requirements and restrictions.- Primary processor responsible for researching and creating narratives for.

Watertown, Massachusetts

- Met face to face with members when they came to our Watertown office. Properly documented and performed follow up as needed.- Attended member meetings and gave presentations during Open Enrollment. Also led "break away" tables where members could have all of their questions answered in small groups.- Served as backup to both the Help Desk and Escalation.

Watertown, Massachusetts

- Professionally respond to and document inbound member calls, striving to ensure first call resolution.- Consistently exceeded company standards for quality on call scores.- Worked to de-escalate calls by conveying empathy and understanding to enhance the member experience.- Understanding that some situations require additional assistance, set proper.

Franklin, Massachusetts