Jamar Phillips Email & Phone Number

In my position I was responsible for Managing all Provider Dispute Resolution and Inquiries. Including being proactive and assess internal system configuration within provider setup and system adjudication. Conduct audits both internal and external and determine the most effective and efficient process to resolve the provider inquiry. Ensure documentation and reports are completed within a timely manner. Ensure that Claims, Audit and Provider Configuration Department are well informed. Partnered with our recovery department to ensure that all overpayments were identified along with outreach to the provider to ensure that they are aware of the overpayment. I maintained accurate and complete provider files. Also, generate internal reports to identify any leakage based on specialty and contractual agreements. Worked closed with the Medical Director for overpayments exceeding $100k. I identify an overpayment exceeding $860K and worked closing with the groups CEO to refund monies. All monies were recouped within a 3 month time span.

Listed skills include Customer Service, Microsoft Excel, Project Management, Microsoft Word, and 11 others.