Supervisoro Ensuring agents understand and comply with all call center objectives, performance standards, and policies.o Working with other supervisors and management team members to support agents and maximize customer satisfaction.o Carries out supervision, coaching, call monitoring, training, reviewing andcorrective actions of all operators/agents.o Monitors operators’ attendance, scheduled shifts & breaks as necessary.Quality Specialist oListening to calls and analyzing for customer service skills according to Providing Peace of Mind guidelines both inbound and outbound and Quality Monitoring guidlinesMedicare Benefit Specialist Tier II & Part B Claims Tier II; oStop/Reissue Beneficiaries ChecksoRequest check copies for claims checks that have already been cashedoCheck Status of Appeals that have been over 60 daysoClaim adjustment escalationsoSubmit escalations for Fraud oCompare Hospitals, Nursing Homes, Dialysis Facilities, and Home Health oExplain the global surgery periodo Explain payment reduction for mental health claimsDurable Medical Equipment Competitive Bidding Program oAssist Callers who currently live in a Competitive Bidding Area find DME suppliers in their area.Durable Medical Equipment Tier I; o Research Claims for Durable Medical Equipmento Help find the nearest supplier in the areao Explain each category of Durable Medical Equipment, Prosthetics, Orthotics, and SuppliesPart A & Part B Claims Tier I; oResearch Claim for Part A & Part Bo Check reimbursementso Submit appropriate Medicare Administrative Contractor Escalationso Research Denied claimso Look up specific procedure codeso Look up Local Coverage Determinations and National Coverage DeterminationsGeneral Medicare Tier I; oAnswer general Medicare coverage questions oCompare/Enroll beneficiaries

Answered phone callsResearched denied and paid claims Helped Patients understand their prescription coverageTricare/Department of Defense prescription claims for retail (TRRX) and mail order (TMOP)Assist with escalated calls from Patient Care AdvocatesAssist with corrections on claims and resubmitted to claims department for processingEntered prescriptions for Pharmacy Filling/Data Entry Contact doctors for new prescriptionsCPhT Trainee

o Answered phone calls for patientso Researched claimso Helped patients understand their prescription coverage