Member Benefit Coordinator
Current• Conduct inbound/outbound telephonic contact with members in a professional manner and maintain phone stats according to departmental key performance indicators for Medicaid, Medicare, and HIX Line of Business • Handles incoming, outgoing, and returned mail as member of Preproduction Team• Ensured members received follow up calls, and providers received requested records in a timely fashion• Proficient in HIX, Medicaid, and Complete lines of business• Acts as a liaison between members and leadership on all issues by deescalating supervisor calls• Certified Training Liaison for the MeridianChoice and MeridianComplete line of business and assists in the training and onboarding of all new hires• Applied a Kaizen approach to producing continuous significant time management results as a team• Elected by Leadership to be a participating member and meeting leader within the Job Aid Committee to ensure job aids and all related materials were in order, easily accessible, and met all SOPs• Attended community outreach engaging events for the MeridianChoice and Medicaid lines of business• Assist members and providers based on assigned skills, including authorizations and claims inquires• Educate members and providers on policies and procedures regarding access to care, grievance and appeal process, eligibility process, HIPAA, rights and responsibilities, and fraud, waste & abuse• Educate members and providers on Meridian Health policies and procedures regarding access to care, grievance and appeal process, and eligibility process• Made appropriate corrections to claims that could not be processed through Claims Vertexting• Completing follow-ups with members to ensure all their concerns have been resolved and guarantee a one-call resolution• Assist in shadowing for future Meridian Choice team representatives• Quit coach for the New Beginnings Program helping members to quit smoking