Trinity Hollins Email and Phone Number

Effectively manage administrative aspects of Pre-service authorization process Effectively manage 20-25 employees to achieve team objectives, including meeting the company’s standards of production and quality while maintaining turnaround timesManage in office and work at home staffMaintain and incorporate an advanced working knowledge of NCQA, URAC, other accreditation organizations, regulatory agencies, and contracted health care plans requirementsAccountable for the accurate and timely processing and response to all authorization documents received by the company in a manner which efficiently and effectively supports the contracted health plans, the company and its customers Respond to and completed provider/member escalations in a timely manner Communicate with provider and/or office staff, various health plans administered by UHC, and/or other UHC employees Perform other projects, tasks and duties as assigned by management

Supervise and monitor the daily operations of intake to ensure quality requirements andstandardsSupervise and motivate team to achieve team objectives, including meeting the company'sstandards of production and quality while maintaining turnaround times Ensure a timely acknowledgement and response to all authorization documents receivedproviding appropriate feedback to address processing issues Administer the process for handling authorizations received from non-participatingproviders Respond to and completed provider/member escalations in a timely manner Communicate with provider and/or office staff, various health plans administered by UHC,and/or other UHC employees Research and verify information provided on authorization documents when appropriateSupervise process for accurate additions of new patients to the patient database Facilitate team staff meetings in order to review and implement processes and betterworkflow Review with management individualized reports reflecting daily production and quality inorder to accurately measure and monitor predetermined company, position and individualgoals Perform other projects, tasks and duties as assigned by management

Requested clinical and discharge information for management teamAssisted outreach team with contact information for nurses and clinical staffAssisted team lead with team management assignmentsSupported nurses with scheduling appointments, generating/sending lettersResearched GAP cases for approval or denialOver custom accounts in the state of Missouri Assisted with Transition and Continuity of Care accountsUnderstanding of CPT and ICD-9 codes

Had daily contact with USNow clientsAssisted clients with needs pertaining to USNow plansKept clients informed of USNow changes and product enhancementsAssisted Account Managers with data entry, client/vendor correspondenceClerical tasks and special assigned projects Assisted Accounting Department bring clients accounts current

Answered questions regarding member's eligibilityVerified benefits/insurance with members, providers and hospitalsWorked with participating pharmacies regarding RX issuesSet members up with contracted radiology/lab facilitiesChecked and quoted re-pricing amount of claimsData entry and processing of claimsWorked with vendors American General, Pan American and Continental AmericanWorked with providers/hospitals within several PPO networksAssisted with Health Advocacy for members with outstanding medical billsUnderstanding of CPT and ICD-9 codes

Handled Inbound and outbound calls resolving patient issuesWorked with internal/external contacts Omnicare, XL Health, Medicare/MedicaidEnrolled /Maintained patient health while in three year Medicare StudySet up time for patient and initial assessments Called patients regarding missing weights due to illness/hospitalizationWorked closely with nurses to help maintain patients health of Heart Failure or DiabetesReceived incoming calls from clients seeking medical adviceAssisted with nurse triage to aid callersTrained to assist with ER, Red Flag and high-risk callsTeam lead in Disease Management departmentAssisted with Quality Management and audits of calls