Shawn Perry Email & Phone Number

United States

1901 Market Street, Philadelphia Pa 19103

Handled the daily reporting of department completed email inquiries, email inventory carry over from prior day, and incoming email inventory for current business day. Provide the number of inquiries completed by team members. Reassign follow up inquiries to team members. Assigned urgent member issues for handling as priority. Handled inquiries with management issues, and high inventory. Assisted team with submission of Management Exception for handling. Communicated with team member when production was not met. Explained the importance of meeting their production individually, and as a unit. Reported trending issues on why inventory was increasing. QA monitoring of team completed inquiries, provide feed back if there were errors. Trained new hires on the email inquiry process, and refresh training of team members as needed. Created policy and procedures. Required to hold a email correspondence dialogue with Customer Service New Hire Class. Explained how the email correspondence department and customer service department worked hand and hand. Explained how they can go under member identification number to see if an inquiry was received in the email correspondence area, as we were able to do the same to see if member concern was handled in customer service. This will keep the member from getting duplicate information.

1901 Market Street, Philadelphia, Pa 19103

Created report for incoming inventory for the business day to supervisor. Reviewed inventory from prior day to see if production was met. Reviewed team members' inbox to determine if there are any member INFOs outside the department 3 day turn around time frame. Advised team member via email if there were INFOs outside of the turn around time frame and to have them handled as priorty before handling any other work. Assigned new work to team members by date range. Assigned priority letter requests from Customer Service Department once HIPPA have be verified that the member or non member have authorization regarding the type of letter being requested. Required to QA monitor a total of 10 completed INFOs per team member per month. Conducted side by sides, coaching, and refresh training to current team members as needed, and trained new hires. Assisted team members with any written correspondence they were having issues closing out. Ordered explanation of benefits summary (EOBs) or provider/facility specific claim information per team member requests, Customer Service Department, or FEP Department. Assigned EOBs (member claim reports) to the requested team member or assign throughout department per team member. Required to hold a correspondence dialogue with Customer Service New Hire Class. Explained how the correspondence department and customer service department worked hand and hand. Explained what information was needed in their info when submiting request to correspondence department, so member request is handled and not sent back for additional information. Advised how they will read a HIPPA form, Confidential form, and what words to listen for to determine if it should be a confidential form. Explained when to submit requests for members EOBs, EOBs (member claim reports) or specific provider/facility claims. Handled member infos and letter requests in department as needed.

1901 Market Street, Philadelphia, Pa 19103

Handled the daily inventory, reviewed team members' inboxes for aged work, assigning written and letter requests as well as priority requests to the team members. Ordered explanation of benefits summary (EOBs) reports for date ranges, and specific provider/facility EOBs requests. Communicated with internal and external members. Made out bound calls to vendors, and attorney offices regarding medical record requests. Assisted team members with difficult written inquiries and letter requests. Handled refresh training of current team members as needed, and training new hires. Trained our New Hire Customer Service team members on the correspondence department process, and how the departments worked hand and hand. Provided policy and procedures regarding submitting requestsfor handling in the correspondence area, and department turn around time outside of priority handling. Required to handle a number of QA monitors for each team member per month. Handled any additional duties assigned.

1901 Market Street, Philadelphia, Pa 19103

Responded to email correspondence from members, providers, non-members, and handled explantion of benefit summaries (EOBs) reports manually. Assisted team member with difficult written correspondences, and letter requests. Handled priority requests as assigned by department team lead. Updated department policy/procedures, handled refresher training for required team members, and training for new hires. Assisted team members with INFOs outside the department time frame.

1901 Market, Street Philadelphia, Pa 19103

Handled assigned written correspondence and letter requests within 3 day turn around time frame. Provided information in wrap-up when INFO was not going to handled within the department turn around time. Handled duplicate explanation of benefits summary (EOBs) requests, and priority requests. Researched member benefits, billing issues, primary care physician (PCP), demographic updates. Forwarded INFOs to enrollment for adding and dropping members. Forward non-correspondence written to appropriate department areas.

1901 Market Street, Philadelphia, Pa 19103

Processed professional and facility claims to adjudication, or rejected/suspended claims. Investigate why claim reject or suspended. Processed claims that needed to be adjusted per members' benefits, not able to adjust within department contact adjusters in the adjustment department. Handled payment and fee scheduling for facility accounts. Provided QA monitoring and counseling to claim associates.