Michael G. Email & Phone Number

Phoenix, Arizona, United States

Phoenix, Arizona, United States

•Data entry of medical service providers into Aetna Medicaid contracted provider directory. •Auditing the contract implementation process between Aetna Medicaid and physicians, facilities and ancillary providers; updating and monitoring progress throughout the contract life cycle as it moves through credentialing analysis and network relationship management.

Tempe, Arizona, United States

•Entry of healthcare claims for reimbursement to policy holders via fringe benefit plans including Flexible Spending Accounts, Health Savings Accounts, Healthcare Reimbursement Arrangements.•Appeals processing and troubleshooting denials for card transactions for policy holders and processing of reimbursement for previously denied claims. Facilitating reimbursement for overturning of denials. •Handled inbound calls from members to provide education on usage of benefits for medical and prescription drug services. Also provided real-time adjudication resolution directly to members.