Barbara Cox

• Assisted members with coordinating care to providers
• Analyzed patient accounts to determine what is needed to pay the claim
• Determined if the claim could be processed while member is on the phone based on procedure codes
• Made outbound calls to providers to get procedure codes and diagnostic codes
• Updated UNET screens within the system for coordination of benefits for Medicare Part A and Part B
• Explained to members how each claim was processed and why they have a particular member responsibility if any

• Received calls from members about automobile payments
• Took Payments over the phone from members
• Developed a strong understanding of bankruptcy policies

. Process claims in internal review status(IR)

. Meet Goals set by the department daily

. Process claims from the ACAS screen

. Process medical and hospital claims

. Process claims for medical and hospital

. Day to Day Provider rework

. Cob claims for medical and hospital

• File Medicare and Medicaid claims
• Contact providers on claim payments
• Connect with patients to reconcile outstanding balances via Zirmed
• Make payment adjustments to accounts as needed
• Assist in making outgoing calls to patients in regards to insurance verification