Marcia Roberts. Aai, Ais,Clcs Email & Phone Number

Macon, Ga, Us

Wilmington, Massachusetts, United States

Manage assigned casework of escalated member interactions and/or complaints in Microsoft Dynamics and other systems by reviewing account history, notes and documentation and providing members with the appropriate follow-up.Handle incoming call volume to the complex case specialty phone line.Ability to read and understand settlement document language.Address and resolve challenging or difficult situations within established turnaround timelines, while maintaining proper documentation in our platforms.Demonstrate proficiency in problem-solving and thinking critically when it comes to resolving member complaints.Communicate effectively with members, as well as internal team members and managers who can help with escalated cases.Ensure familiarity with the most up-to-date policies and procedures, as well as recognize potential additions or modifications to these as needed.Share opportunities for learning and development with management and other team members.

I utilized my diverse skill set and passion for healthcare administration while successfully scheduling appointments, meticulously filing maintenance reports, accurately providing insurance verification, and maintaining organized medical records. By efficiently managing appointments and ensuring smooth scheduling processes, I contribute to exceptional patient experiences. Additionally, my expertise in insurance verification and meticulous record-keeping ensures seamless administrative operations and supports the delivery of high-quality healthcare services.

In this role I excelled at compiling accurate insurance information for both potential and existing patients. I lead communication and collaboration efforts for hospitals, physicians, and skilled nursing facilities to ensure seamless referral placements. Additionally, my expertise lies in billing insurance companies and skilled nursing facilities, collecting payments, facilitating claim payment audits, generating daily reports for leadership and finance teams, and negotiating insurance company contracts.

As a Lincensed sales agent I consistently generated new business by leveraging powerful ITC Turborater tools. I specialized in using the advanced AMS system, I efficiently handled policy renewals, change requests, endorsements, discounts, and addressed any billing questions from clients. I have a proven track record conducting meticulous research on delinquent accounts to identify and resolve missing payment discrepancies, ensuring a seamless customer experience.

Proficient in routing confidential medical requests to local, state, and federal agencies. I successfully managed over 1,000 patient accounts monthly, while providing clear explanations of covered services to clients. I was also responsible for analyzing customer data for accuracy and created and presented insurance coverage proposals to potential clients.