•Energetic and knowledgeable customer service/administrative support
•Proven ability to complete assignments accurately and efficiently
•Possess strengths in professional customer interaction, research and problem solving regarding customer care
•Skilled in Microsoft Word, Excel, and Access
•Knowledge of medical insurance processes and medical data entry including ICD-9 and CPT codes
Process letter requests by manual or automated databases, typing customer service notes in system, pulling Rx, and processing member correspondence.
Work Rx pull requests, rescan, and work with RPh to obtain appropriate documentation to resolve request.
• Controls work includes data input / validation, Quality Assurance (QA), Prescriber and Patient outreach, and working with RPh and Pharmacy per work instructions, P&P, management direction, or any national or state regulations.
• Completed and process data for analysis.
• Prepare and organize work for storage both on and offsite.
•Received pre-authorization requests from referring physician offices via telephone
•Utilized the Informa-HR system efficiently by inputting patient information
•Referred cases to the medical department for review as appropriate
•Received verification requests from rendering providers via telephone utilizing Informa-HM system
verifying registration information and log verification data in database
•Provided information to referring/rendering physicians regarding network imaging centers and other issues
related to NIA covered service
•Performed data entry of ICD-9 and CPT codes into system
•Maintained 454 pharmacy's retail computer hardware and software
•Monitored pharmacy label printout, identified and corrected error to ensure accurate information
•Improved revenue retrieval from 94% to 98%
•Managed integrity store system database and related files for stores