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ENROLLMENT AND ELIGIBILITY: Assist with issues involving Medicare Special Elections for enrollment into Medicare Advantage Plans.Correct enrollment applications and submitting missing information to aid in enrollment completion. Verifying prior medical and prescription coverages for Medicare use.Correcting and verifying address information to ensure members are in correct service areas for HMO/PPO plans. CLAIMS AND BENEFITS: Review plan structure and copayment amounts with members.
• Verifying claims are processed in accordance with benefits and settling claim disputes with healthcare providers. BILLING: Educate members on premiums and processing payments.Ensure premiums match with government subsidy amounts when applicable.Set up automatic payments from bank accounts, card accounts, or social security benefits. EXPEDITED APPEALS: Assist members, members’ family, and healthcare providers in submitting fast appeals for urgent medical review. Educate on Medicare guidelines for expedited appeals and confirm and forward appeal decisions and determinations. ACCESS TO CARE: 
Assist members in situations where they have trouble attaining referrals from providers, getting proper documentation submitted for pre authorization, or accessing urgently needed medication. 
INTERNET RESPONSE TEAM: Answer online member inquiries within 24 hours of inquiry submission. 
ELECTRONIC CORRESPONDENCE HANDLING SYSTEM: Responsible for sorting incoming faxes and mail submissions from providers, members, and potential enrollees - forwarding documentation to proper departments for handling.

Ran food to tables, took orders, processed payments and seated guests. Responsible for keeping tidy dining areas and restocking tables at the end of shift.