Collected and documented ordersResponded to inquiries and issuesAnswered customer inquiries pertaining to pharmacy orders, benefits and PCP questionsManage multiple EMR systemsManaged customer accountsResolved customer issues

Confirmed their diagnosis and CPT codes for the requested procedures/ visits and then contact the insurance carriers or case workers to obtain necessary authorizations.Worked with the pain clinics, responsible for creating new accounts for upcoming cosmetic procedures.Processed approvals and denials.Researched existing authorizations billing information to ensure services are not duplicated.Sent provider and client authorization information.Communicated, verified the contact information directly with the provider before resending due to HIPPA Laws.Works with Enrollment, Member Services and Premium Billing to resolve member complaints regarding their enrollment.

Provide detailed education to recent recipients of the Arkansas Works Medicaid Coverage Program, while adhering to update needed information into EMR systems accordinglyUtilize multiple state-based systems to determine qualifications, eligibility and service for recipients of the program.Communicate effectively with customers/recipients. Develop and maintained working relationships as necessary to meet contract deliverables of specialty area project.Maintain knowledge in other areas of Member services to assist as need with the overall operations of Member Services departmentDedicated to demonstrating exceptional customer service to all recipients with technical support problems via portal; maintain communication with client while researching issue.

Coordinate and process medical financial assistance applications in accordance to federal property guidelines in a timely and accurate manner.Maintain ongoing communication with patients regarding eligibility and prospective MFA status; work closely with Leadership to determine overall approval of system generated income verification purpose.Keep detaild record of patient eligibility, approval, and expiration dates of submitted MFA application in Health Connect (EPIC). Scanned all documents required for approval into files in accordance to patients approval or denial of MFA.Demonstrated exceptional customer service to all patients encountered via phone or email

Obtained complete and accurate demographic and financial information from a variety of sources, including patient interviews.. Entered data in computer and thoroughly documented any incomplete admissions/registrations in manner prescribed. Obtained pre-certification, referral or authorization number and updated patients' file.Gave demographic information to insurance companies and called physicians' offices if clinical information is needed for pre-certification and verified the information obtained.

Verified patients' insurance eligibility and collected patient responsibility payments.Responsible for medical necessity coding for Medicare patients.Promptly and compassionately greeted and assisted all patients in a timely manner.Completed compliance checker process in accordance with regulatory and Conifer guidelines.