• Performed complex reviews of all appeal documentation provided by the beneficiary, provider and/or representative.• Independently rendered a reconsideration decision in accordance with Medicare laws, regulations and statutes.• Created and implemented companywide training materials.• Maintained good rapport with clients through both oral and written communication.• Department expert for the Fiscal Intermediary Standard System (FISS), Health Insurance Master Record (HIMR) and Medicare Administrative Contractor (MAC) policies. • Worked hand-in-hand with management to develop solutions for high profile appeals.• Assisted with Administrative Law Judge (ALJ) remands, Medicare Secondary Payer (MSP) and multi-beneficiary appeals.

• Knowledge of company services, products, insurance benefits, providers contracts, and claims.• Analyze problems and provide solutions for customer questions via telephone and written correspondence regarding insurance benefits, providers contracts, eligibility and claims.• Operate a PC/image station to obtain and extract information; documents, activities and changes in the database. • Develop and maintain positive customer relations and coordinate with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

• Promoted the company by establishing trusting relationships with potential clients• Responsible for taking on new employees and providing the necessary training for success • Filled in as an inbound marketer, handling client’s questions and concerns, as well as backing up all of the outbound marketers with the promotional sale.