Derek Malicki Email & Phone Number

Cleveland, Ohio, United States

• Respond to inbound customer inquiries from members and providers while helping answer their questions about medical plan details, claims, and other concerns• Educate members on what is covered/not covered on their medical plans, advise what doctors/hospitals are in their networks, provide general knowledge of health care such as their deductibles, coinsurance and how they are applied on their plan• Provide members a breakdown on how the claims process works in health insurance and help them get the most out of their health plan• Send new ID cards and benefit booklets to members when needed and help them navigate the My Health Plan website• Inform members of monthly premiums and estimated cost of services when necessary• Adjust medical claims for providers when necessary per medical guidelines after extensive research is performed • Assist providers in giving plan eligibility and benefits by running procedure and diagnosis codes in our main system to specify coverage• Support management by mentoring new staff as a Peer Ambassador, provide warm welcome to the company, answer their questions about MMO, and assist with initial systems setup• Adhere to daily department goals regarding adherence, first call resolution, after call work and CSTAT

- Responsible for updating assigned work orders- Bills client/contractor invoices per client parameters- Conducts and researches current orders per client parameters to ensure quality standards-Submits daily production goals of 12 orders per hour

Pulling leads for business owners to assist them with their sales.Building database of qualified sales professionals and owners in the printing and promotional products industry that are looking to grow their business or build equity in their own distributorship.

Ensure that all quality records, SOPs, work instructions, test reports, are current, complete, up to date and properly maintained. Assist in development of CleveMed's ISO 13485: 2003 quality system in preparation for certification audit.Wrote web content, letters, direct mailings, etc.

I assisted managment with the development of project plans, facilitated resources, ensured that partnering companies were on task and made deadlines, scheduled meetings, and performed other needed projects under the direction of management.

Wrote news articles, interviewed people, pitched story ideas to editors.