- Responsibilities are handling calls and offline tasks related to claims and benefit inquiries for healthcare providers. Mainly assisting about claims denials and concerns, providing resolution to appeals and predetermination request, and handling concerns for provider related to network/contract issues.
- Proficient in PowerPoint Presentations, Organizing documents, and Basic Excel spreadsheets.
- Knowledgeable on using RUMBA software tool and GPS (Guided Personal System) tool for assisting provider related concerns to patient's claim and insurance benefits data, demographics, provider network contracts, and claim denials.
