Advocate
CurrentEducate Members on how their benefits plans workI often travel for Client Meetings and Health Fairs• Effectively answer questions from Members, Insurance Companies and Brokers• Mentor new employees and make sure they have the tools to be successful in their position• Reviews Medicaid and Medicare Explanation of Benefits for accuracy• Write appeals and medical necessity letters• Negotiates discount with Providers and Collection Agency• Review EOB’s to make sure they… Show more Educate Members on how their benefits plans workI often travel for Client Meetings and Health Fairs• Effectively answer questions from Members, Insurance Companies and Brokers• Mentor new employees and make sure they have the tools to be successful in their position• Reviews Medicaid and Medicare Explanation of Benefits for accuracy• Write appeals and medical necessity letters• Negotiates discount with Providers and Collection Agency• Review EOB’s to make sure they are processed according to the plan benefit• Help members through their Open Enrollment choices* Well versed in all insurance plans to be able to explain coverage, plans types, and provide financialcounseling to the insured.* Identify problem payments such as recoupments, overpayments, and low remits. Make sure allclaim are processed, appealed, and filed in a timely fashion.* Handled all Medicaid rejections, partial pays, adjustments and denials* Serve as the primary contact for patient reimbursement issues, provide information foralternative financing, recover payments from third party payers in a timely fashion, and verifybenefits, coverage and limitations. Show less
