Tierra Wright Email & Phone Number

•Appoint and terminate agency/agents in Siebel and on Department of Financial Service (DFS) website.•Set-up and maintain channel partner data in multiple systems/databases in compliance with SOPs and data integrity safeguards.•Research, gather, and validate channel partner information via online sources including various government websites and communications with business partners (e.g., Field Sales Offices, Small Group Enrollment Organization, Telesales, Agent Service Center).•Update Siebel records with appropriate AOR record changes.•Provide proper notification to new and existing Agencies as well as Groups regarding changes to the Agent of Record.•Manage the Service Record in Siebel, ensuring all requests are properly documented, all request notes are updated, all pertinent documentation is attached and the request is closed out.•Document, update or modify agreement data and Agent of Record information in appropriate systems in timely accurate manner, and escalate issues effectively to avoid negative impacts to compliance or sales outcomes.•Enter and update the following types of data in multiple systems, ensuring corresponding processes are completed:•Designated Producer Agreements•Sole Proprietor and Legal Entity Requests and Contracts•Termination Requests•Reinstatement Requests•Proof of Errors and Omissions (E&O) Insurance•W-9s•Document channel partner information management activities (e.g., agent/agency adds, agency tax ID updates, terminations, reinstatements, etc.) using Siebel/Agent Point service requests to enable activity tracking and capture performance data.•Execute binding agreements and distribute welcome packets, denial and termination letters.•Managed the Service Request (SR) in Siebel/Agent Point, ensuring all requests are properly documented, and all pertinent documentation is attached.

Provide analytical, technical problem-solving support to Medicare and other Government contract providers, vendors, billing services and clearinghouses. Analyze, troubleshoot and support EDI telecommunications via Secure File Transfer Protocol (SFTP), SPOT portal and Direct Data Entry (DDE) technology as well as other EDI services and ANSI ASC X12 format transactions.

Make independent decisions relating to claims processing accuracy relying on online reference tools. Research and decision making skills to respond to inquiries in accordance with Medicare procedures and guidelines.Thorough and knowledgeable of Medicare policies and benefits, internal processing instructions, as well as medical terminology.Manage task and assignments in a timely manner with appropriate attention to detail.