Raymond Cherry Email & Phone Number

Principal Duties and Responsibilities: • Processing prescription insurance claims using a combination of off the shelf and customized computer-based applications • Verifying patient, prescription and third party payer information to ensure efficient, effective and valid claims adjudication • Assuring that all third party (insurance) adjudication processes are completed in accordance with company protocol. • Reviewing and investigating all rejected claims to identify issues and solutions • Calling insurance carriers, physicians’ offices and patients to acquire additional claims information • Determining correct claims payment or denial for reimbursement • Identifying and elevating questionable claims, authorizations, or system issues to the proper management authority as appropriate • Reviewing electronic claims and processing additional data into the claims system as necessary • Resolving computer generated edit conditions, determining correct payment or denial amounts and documenting the appropriate process • Researching and processing claims payment adjustments as a result of customer service referrals, audits, or data inaccuracies • Learning, understanding and abiding by all company policies and procedures • Exercising the highest level of professional ethics in interpreting prescription claims data and contracts

General Contractor. All areas of construction.