Jina Bethea, Mha Email & Phone Number

Responsible for researching and resolving written, phone and internet complaints and complex or multi-issue appeals submitted by consumers and physicians/providers to UHG executives, state attorney generals and other regulatory agencies. Conduct root cause analysis by identifying potential compliance, process, or systemic breakdowns; communicate findings to management; ensure appropriate actions are being taken for process improvement.

Responsible for the installation and administration of assigned contracts, including, but not limited to: structure and billing set up, eligibility collection, database loading, and preparation of plan materials such as administrative documents and provider education materials. Positions are also responsible for overall provider contract and amendment loading and processing using various databases. May include auditing contract loads for adherence to quality measures and reporting standards.

Responsible for providing expertise and customer service support to members as part of our UnitedHealthcare model. Direct phone-based customer interaction to address complex member needs and provide recommendations on services that may help close gaps in care for the member and/or the member’s family. Authorized claims payments or refer claims to investigators for further review.Responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.

Responsible for providing expertise and customer service support to members as part of UnitedHealthcare model. Direct phone-based customer interaction to address complex member needs and provide recommendations on services that may help close gaps in care for the member and/or the member’s family. May authorizes claims payments or refer claims to investigators for further review.

Responsible for providing expertise and customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries.

Master Of Health Adminstration, Health/Health Care Administration/Management

Bachelor Of Science - Bs, Computer And Information Sciences And Support Services, Senior