Russell Adriano Email and Phone Number

Managing Several Clients for Subrogation, Managing people with different client, Facilitating coaching and Business Reports  Supported a 2 Teams with total of 23 headcounts – Different client for Subrogation, Lien resolution and Recovery Facilitate coaching for MTD, EOM Coaching and IQA audit. Do business review with cients Discuss with client’s current case load on the team Maintain quality and provide guidance where agent lack.  Discuss updates and ensure the team is calibrated. Maintain qualify report (Subrogation Internal Quality) Manage inventory for recovery files.

(Health Care account) Do Coaching, Facilitating Training, Reporting, Inventory and writing process document for Subrogation Publish 16 process documentation for the account which are being used by offshore team and onshore. Head POC for Engagement Activity for site of Makati and Alabang Supported a Team with 6 total head count. Facilitate coaching for MTD, EOM Coaching and IQA audit.  Audit events processed. 70 events per month To conduct regular feedback sessions for agents Maintain quality and provide guidance where agent lack. Discuss updates and ensure the team is calibrated. Maintain qualify report (Subrogation Internal Quality) Track and monitor inventory. Create Process Knowledge Test (PKT) Monthly

(Health Care Account) Auditing events, Checking Projections and Settlements etc..  SupportedaTeamwith6totalheadcount. Facilitate coaching for MTD, EOM Coaching and IQA audit.  Audit events processed. To conduct regular feedback sessions for agents Maintain quality and provide guidance where agent lack. Discuss updates and ensure the team is calibrated. Maintain qualify report (Subrogation Internal Quality) Track and monitor inventory.

(Health Care Account) Negotiation with Attorney and Insurances. Subrogation and other Court Document Related.  Investigates, evaluates, and negotiates healthcare subrogation matters with an annual recovery goal from $1M to $5M. Comprehend the nuances of Medicare, Medicaid, Self - Funded ERISA and Non - ERISA related health insurance subrogationrecoveries and reimbursements to analyze and move cases to recovery for the clients, including the negotiation of dollars thatwill be returned to the plan. Research applicability of laws, regulations and other requirements to cases, contracts or decisions Analyze data and interpret legal research to make conclusions. Present results of analysis in writing and / or verbally to supports the Plan's rights. Maintain working knowledge of ERISA and ensure adherence to state and federal subrogation laws. Utilize your understanding of and expertise of coverage, policy interpretation, contract interpretation, case law, state / federalregulations Identify, monitor, and evaluate data to determine third party liability and reimbursement amounts; ongoing analysisof medical treatment to evaluate relatedness. Ensure compliance with Health Insurance Portability and Accountability Act Conduct a high volume of outbound calls and expeditiously send out or respond to electronic, written and verbal inquiries to /from attorneys, insurance companies and health plan members.

(Health Care Account) Supervisor Call, Managing a Team and Facilitating Coaching Supported a Team with 20 total head count.  Supported Nesters Do coaching/Feedback. Do call listening. Have individual project for the whole site.  Discuss updates. Conduct Trainings

(Health Care Account) Member Services, Processing Claims, Billing and Policy Reinstatement Received “Best Agent of the Month” award for 4 times.  A significant contributor. Received 98% positive customer survey satisfaction.  Open Enrollment Champion for 2018. 4C Plus E Champion. Best FCR/ASAT/IRR for 5 times (Year 2018) Claims Trained Highest Evaluated Score for Claim Nesting.

(Health Care Account) Providing Eligibility and Benefits for Provider Received 96% positive customer survey satisfaction. Speed on calls was above required Average handle time Deal with Customer benefits. Perform intense billing reconciliation process