Promoted to senior CSA due to exceptional job performance in nine months.• Given additional client contracts to service, including WIN’s premier contracts, including Goldman Sachs and JP Morgan Chase.• Set up prior authorizations for the patient seeking treatment. This includes benefits comparison, treatment requests, and patient benchmarking.• Assist claims and go over accumulator balance with patients,including reimbursement of out-of-pocket expenses.• Serve as contact for insurance companies regarding medical disputes.• Go over all insurance benefits and send prescriptions to pharmacy.• Email and locate in-network providers for fertility treatments, and scheduling patients for consults.• Verify patient insurance• Data entry/medical historyTechnical systems experience:ATS: Fertility specific platform, OBIS, Navinet

Primary service representative for three enterprise clients (Anthem, Amerigroup and Humana) Utilize EZCAP,KeyCAP, MAXvault, and IDM systems to quickly ascertain client information for swift patient claim resolutionLisase with medical management, and other in-house departments to resolve provider questionsResponsible for checking customer query status. Resolve customer complaints and fax request forms.Comply to HIPPA regulations & protocolsQuery CPT codes Develop a professional relationship with provider offices and managed care personnelUnderstanding of all medical management protocols to be able to respond to provider inquiresCommunicate OrthoNet policies and procedure to providersRespond to provider telephone inquiries pertaining to eligibility verification and authorization protocols as well as general medical management policies and proceduresVerify and update, as necessary, provider information in OrthoNet’s information system.Document inquiries requiring consultation in OrthoNet’s Customer Service System and assist providers in resolving any concerns/problems providers may encounterWork with OrthoNet’s Case Managers and Contract Assistants to assure that information and expectations are communicated in a consistent and effective manner.Take up to 80 calls a day.

Manager, trained, supervised servers FOH Resolve customer complaints quickly and efficiently.Server/Hostess

- Handled large call volume on a daily basis.- Scheduled doctor's appointments, coordinated medication refilles with pharmacies and filed customer grievances.- Helped resolve insurance disputes with patients.

- Serviced high-end clientele at fine dining establishment.- Trained new employees on various tasks and responsibilities.