Destiny Smith Email & Phone Number

• Converse with Physicians to schedule peer to peer conversations• Complete all documentations associated with post-acute denials• Relay denial reasons from MD rationale • Communicate with providers and physicians to review additional options throughout the denial process• Create DENC (Detail Explanation of Non-Coverage) letters as requested by various Health plans • Conduct inbound and outbound notifications via email and phone as required• Knowledge of appeals process for various health plans

• Contacted personnel for those involved with members’ transition to and from post-acute care facilities• Communicated inbound and outbound requests and notifications between EviCore stakeholders and external hospitals• Interpreted policies involving multiple health plans to ensure state compliance of Medicare and Medicaid guidelines• Addressed and resolve issues that arise with pre-certification process• Reviewed faxed documents to verify PHI is adhered to• Communicate with support to confirm member eligibility as needed

• Coded complaints based on equipment errors/ malfunction• Thorough reading of issues if multiple problems were found at once• Research of coding projects as assigned• Internal follow up with engineers for resolutions of the complaint• Followed internal guidelines to ensure coding was in regulation

Franklin, Tennessee

• Contact personnel for those involved with members’ transition to and from post-acute care facilities• Communicate inbound and outbound requests and notifications between EviCore stakeholders and external hospitals• Interpret policies involving multiple health plans to ensure state compliance of Medicare and Medicaid guidelines• Address and resolve issues that arise with pre-certification process

Nashville, Tennessee

• Assisted with event planning and management• Contacted companies for low level sponsorship and donations• Created sites to increase volunteer recruitment for annual Tour de Cure• Involved with planning, distribution of materials, and execution of Tour de Cure event

Rochester, New York Area

• Under the guidance and mentoring of administrator, shadowed administrator, observing and par-taking in day-to-day tasks • Assigned to perform administrative tasks involving copying papers; filing of confidential forms and faxing. Also created data sheets• Attended meetings and was assigned as the official note-taker for the meetings

Rochester, New York Area

• Assisted team members with event planning and management• Performed clerical duties including answering telephones and taking messages • Copy, file, fax and other associated tasks involving classified documents• Provided assistance to patrons of the Healthy Living Library by implementing procedures• Assisted with newsletter content and design• Participated in health fairs