Ramses Rivera Email & Phone Number

Puerto Rico

United States

Puerto Rico

• Authorized appropriate payment or refer claim for further investigation
• Review, process, rework, and direct all types of medical claims.
• Investigate, researched, and adjust claims.
• Provided support to other medical teams.

Guaynabo

• Assisting the supervisor with maintaining a highly motivated team.
• Help collages work together and ensure they are delivering good customer service.
• Monitoring clerk performance individually as a department, bring issues to the attention of manager as needed
• Handling associates relation activities, communications, and investigations.
• Assist with processing disputes/appeals.
• Organize, delegate, and monitoring the work load.

Supervise work progress of employeesPrepare progress report of employeesWork with the ILR incident reportPrepare administrative hearing to be sent to Highway Transportation AuthorityPrepare verification count of the department of paymentFurther investigate special cases and call clients to inform of possible solutions Give support to the appeals department.

Classify and log to the system appeals received Investigate and process appeals receivedManagement of specific appeal cases Processing of payments received Work with multiple violation notice Quality and assurance multiple violation notice

Verify policy information of clientsPrepared voucher equivalent to payment of compulsory public insuranceWork on renewal of auto insurance for clients

Repair and computer maintenanceDiagnostics, solutions and upgradesTechnical support to business clients Customer servicePrepare inventories