Robert Frank Email & Phone Number

New Haven, CT, US

New Haven, Connecticut

Coordinates all aspects of the outpatient/inpatient referral and pre-certification process including medical necessity, contract, and benefit eligibility review. Provides authorization for inpatient admissions, outpatient pre-certification, prior authorizations and post-service request, data entry and provider correspondence. Conducts the clinical.

North Haven, Connecticut

• Responsible for reviewing, authenticating and verifying several different health insurance plans, carriers, benefits and coverage.
• Obtains prior authorization and pre-certification via telephone and online database
• Review clinical information, Progress Notes, Diagnosis' C-Pap, Bi-Pap, Sleep Studies and interact with Doctors, Nurses, Licensed Clinicians and Utilization Management for approval of services.
• Knowledge of health plan benefits, cost shares, deductibles, co-insurance and co-payments for Medicare, Medicaid-Husky, Wellcare, Anthem Blue Cross & Blue Shield, Aetna, United Healthcare, Harvard Pilgrim, Access.
• Ability to coordinate and communicate benefits to customers, Medical offices, Rehab & Nursing homes and Hospital Facilities.
• In-depth knowledge of specific benefits for Durable Medical Equipment and the process for submitting claims for reimbursement.

Middletown, CT

• Travel to Connecticut nursing homes & deliver supplies.
• Organize, maintain, restock and overlook other Mobilex satellite offices in the state of Connecticut.
• Deliver and pickup holter monitor/EKG' machines from nursing homes.
• Meet with Phlebotomists and bring blood draws back to the lab for analyzing.

Wallingford, CT

• Utilization Management Representative
• Responsible for coordinating cases for precertification and prior authorization review.
• Primary duties may includes, but are not limited: Managing incoming calls or incoming post services claims work.
• Determines contract and benefit eligibility; provides authorization for outpatient precertification, & prior authorization
• Refers cases requiring clinical review to a Nurse reviewer.
• Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate.

North Haven, CT

• The ability to communicate effectively with customers as well as with other sales associates.
• Assist customers with locating products in the store and ability to explain product features and benefits.
• Provide thorough knowledge of the products and provide a comfortable level to proactively approach customers to answer
• questions they may have about a product.
• count the morning register to make sure the store has the correct amount of money and change for the day, be able to reconcile the cash register upon closing, handle returns and exchanges on any item, as well as count.

Branford, CT

• Responsible for cleaning vehicles using specialized cleaners and equipment for all areas of the car, including the interior and under the hood.
• Complete touch up work on the car, including minor repairs and painting.
• Use manual dexterity and bodily coordination to perform an array of tasks to vehicles.
• Wash the exterior of vehicles using various cleaning solutions, also wax and buff vehicles using cloths and buffing machines.
• Inside of the car, typically vacuum to remove dirt and debris, clean upholstery and surfaces, use air compressors and cloths to dry surfaces.

New Haven, CT

• Organize, purge and maintain radiology films and sending films or related medical information to other medical offices as requested.
• Utilize technology for up-to-date record keeping and adhere to all OSHA, HIPPA and compliance/regulatory guidelines as applicable, as well as all Sizewise policies and procedures.
• Asssist in transportation of portable ultrasound machine delivery / pick-up and in-servicing to health care professionals to various medical offices in the geater New Haven area via company work van.
• Maintain a clean and safe work environment by Cleaning, rearranging and recycling outdated items including machinery and office equipment.

Associate'S Degree, Criminal Justice Administration, 3.78

High School Diploma, Business