Lisa Anderson Email & Phone Number

Greater Nashville Area, Tn

Assisted medical practices with enrollment to submit claims and receive electronic remittance advice through Change Healthcare.Maintained relationships with vendor clients and their practice clients.Managed time-sensitive goals for enrollment completion.Updated practices weekly on the progress of enrollments.Set up electronic connections for claims submission and ERA receipt.

Greater Nashville Area, Tn

Assisted members and applicants of Tenncare, the state of Tennessee's Medicaid program. Answered queries and help resolve eligibility and other issues, Updated member contact information and case information.Added and removed members to cases and took applications for new members or different benefits.Referred callers to other agencies as needed.

Greater Nashville Area, Tn

Supported a team of Provider Enrollment specialists to ensure that CHS providers can be reimbursed by the health insurance policies and program. Helped maintain the company's VISTAR database, and archive digital copies of documents such as medical licenses. Regularly contacted the health insurance companies to find out what information they need or the status of a request, and send them the necessary information by fax or e-mail. Update providers' CAQH profiles, filled out credentialing applications, and perform other tasks as necessary. This position relied heavily on multitasking, prioritization, flexibility, and the ability to communicate effectively with co-workers, medical office staff and other organizations.

Greater Nashville Area, Tn

As a customer service representative for Windsor Health plan, I answered calls for a Medicare Advantage health insurance program. The matters with which I assisted my callers included eligibility, supplemental benefits, and questions about their premiums. In the interest of the goal of one-call resolution, I performed follow-up calls and routed tickets to other departments within Windsor as necessary.

In this position, , I answered phone calls from medical providers, health plan members and health plan representatives regarding requests for outpatient radiology. I created new cases for review and performed customer service on existing cases. I was selected to assist with on-the-job training of new employees ("nesting") as well as for MSI's Texas Medicaid pilot group. Later on, I was selected as a Quest Team Coordinator As a MedSolutions As Quest Team coordinator, I handled appeal requests on denied cases, initiated reconsiderations or scheduling peer-to-peer conferences with MedSolutions doctors according to health plan policy. I also took over escalated calls from callers asking to speak to supervisors or from Intake representatives requiring assistance. The health plans clients of MedSolutions include Cigna, Aetna, and Blue Cross/Blue Shield, as well as Medicare Advantage insurance products and state-run Medicare programs. My roles in the call center roles required HIPAA compliance, adherence to call center metrics, interaction with other departments, and thorough documentation of each call, as well as keeping current with the unique and evolving policies of multiple clients. During my time in the call center at MedSolutions, I also took calls on the Spanish queue.

Master'S Degree, Communication, General

Paralegal, Legal

Activities and Societies: Received paralegal certificate and completed internship with the Human Resources department at Logan's Road House.

Bachelor'S, Spansih And Political Science

Activities and Societies: Was part of Spanish Honor Society; also studied abroad in Ecaudor and Germany.