Brandy Fason

Referral/Claims Specialist

• Providing excellent customer service to all incoming/outgoing callers.
• Answering and documenting inquiries related to dental benefits, eligibility, provider information, claims, pre-estimates/pre-authorizations, grievance and appeals, fulfillment requests and other miscellaneous inquiries.
• Handle inbound and outbound inquiries from members, providers, groups, from all regions and lines of business, related to all facets of Member and provider services.
• Assisting members and providers with detailed information on Eligibility, Benefits, Dental History.
• Educating members on benefit/ plan guidelines, criteria, frequency, and limitations for billing.
• Verifying claim status for members, provider, group, etc.Submiting claims, pre-authorizations, and referrals for corrections and void request, if necessary.
• Submitting experience request for Pre-authorizations and Referrals.
• Advising providers on submitting corrected claims and advise on any missing supporting documents, x rays, narrative, etc.
• Assisting providers and members with portal login issues, resetting passwords, submitting, viewing claims, etc.
• Sending claims for adjustments and reprocessing.
• Requesting duplicate EOBs for a members or providers.
• Sending request for cancelled check copy, to reissue a check, or request a stop pay/do not reissue on a check.
• Providing follow-up on issues by making outbound calls when necessary.
• Sending resources to members and providers via email.
• Submitting complaints, grievance, and appeals on behalf of member or provider.
• Advising providers on credentialing status, contract info and fee schedule details.
• Provide follow-up on issues by making outbound calls when necessary.
• Sending resources to members and providers via email, text, and mail.
• De-escalating dissatisfied member and provider calls.
• Assisting providers with contract related inquiries and demographic updates.
• Independently problem-solving, ensuring accurate information is given, while providing great customer service, and achieving first call resolution.

UM/ Dental Care Outreach Specialist
Worked with Utilization Managements DCO team: worked in a DCO specialist position from March 2022 until September 2022. My duties working in this position included but were not limited to:

• Reviewing request in Pre-Estimates/Pre-authorizations sent by our Dental Consultant(DC).
• Determining what's missing, needed, it what the DC is requesting for further review of PE.
• Reaching out to Dental Provider/Office by phone and/or fax to request corrections, narratives, X-rays, documents, etc.
• Attaching any fax sent and documenting the outreach attempts.

• Provide quality customer service, Telecommunications, and video support to users all over the world in a dynamic and fast paced environment
• Provided over-the-phone and online troubleshooting support (calls and self-service) for users with varying degrees of skills
• Triage and troubleshoot all manner of telecommunication and video issues, including account/authentication issues, hardware and software issues, network and VPN issues, and issues relating to mobile devices.
• Provide detailed documentation of steps taken to resolve user’s issues within the ticketing system; including initial diagnosis and all pertinent information
• Unlock accounts and reset passwords for users on multiple networks
• Install common software via endpoint management systems
• Resolve at least 70% of all interactions on first contact
• Provide users with the status of their open ticket(s) and serve as intermediary between users, technical support groups, Third party vendors.

• Efficiently and accurately enter data from electronic or paper formats into the COPIA lab system or other identified database systems
• Maintains data entry requirements and follows data program techniques and procedures.
• Quickly identifies any discrepancies in demographics and resolves accurately
• Processes reports as instructed to support for COVID-19 reporting Other data
• And administrative duties as assigned.

• Providing Medicaid/ Insurance coverage assistance to providers and members
• Answer provider and member inquiries regarding Medicaid policies by obtaining client information and answering benefit inquiries.
• Servicing customers by determining requirements, answering inquiries, resolving problems, and fulfilling callers requests.
• Documenting calls accurately and in a timely manner.
• Researching and resolving claim denial codes and issues. Answering
• Provider enrollment inquiries.

• Interviewing/ Hiring Frontdesk and Housekeeping staff
• Training Frontdesk staff
• Ordering hotel products when low
• Register and assign rooms to guests
• Confirm phone and online reservations
• Respond to guest needs, requests, and complaints
• Collect payment from departing guests
• Keep records of occupied rooms and guests
• Communicate pertinent guest information to designated departments
• Completing Night Audit paperwork
• Completing end of month paperwork

• Providing Medicaid/ Insurance coverage assistance to providers and members
• Answer provider and member inquiries regarding Medicaid policies by obtaining client information and answering benefit inquiries.
• Servicing customers by determining requirements, answering inquiries, resolving problems, and fulfilling callers requests.
• Documenting calls accurately and in a timely manner.
• Researching and resolving claim denial codes and issues.
• Answering Provider enrollment inquiries.

• Customer support for AT&T mobility customers
• Research and resolve billing issues, Troubleshoot and
• Resolve service and device issues, Process payments, as well as offering products and services available through AT&T

• Oversee the daily performance of computer systems.
• Answer user inquiries regarding computer software or hardware operation to resolve problems.
• Set up equipment for employee use, performing or ensuring proper installation of cables, operating systems, or appropriate software.
• Install and perform minor repairs to hardware, software, or peripheral equipment, following design or installation specifications.
• Read technical manuals, confer with users, or conduct computer diagnostics to investigate and resolve problems or to provide technical assistance and support.
• Develop training materials and procedures, or train users in the proper use of hardware or software. Wipe and refurbish old PCs and setup for use in school.

• Analyze network data to determine network usage, disk space availability, or server function.
• Evaluate local area network (LAN) or wide area network (WAN) performance data to ensure sufficient availability or speed, to identify network problems, or for disaster recovery purposes.
• Install new hardware or software systems or components, ensuring integration with existing network systems.
• Test computer software or hardware, using standard diagnostic testing equipment and procedures.
• Analyze and report computer network security breaches or attempted breaches.
• Train users in procedures related to network applications software or related systems.
• Design, build, or maintain web sites, using authoring or scripting languages, content creation tools, management tools, and digital media.
• Perform or direct web site updates.
• Write, design, or edit web page content, or direct others producing content.
• Back up files from web sites to local directories for instant recovery in case of problems.
• Incorporate technical considerations into web site design plans, such as budgets, equipment, performance requirements, or legal issues including accessibility and privacy.
• Respond to user email inquiries, or set up automated systems to send responses.
• Identify or maintain links to and from other web sites and check links to ensure proper functioning.
• Register web sites with search engines to increase web site traffic.
• Install and configure hypertext transfer protocol (HTTP) servers and associated operating systems.

• Designed and maintained Intranet for Billing Corrections department, Customer Billing corrections- scan bills for errors and recalculate amounts to fix billing errors.

• Greet, register, and assign rooms to guests of hotels or motels.
• Verify customers' credit, and establish how the customer will pay for the accommodation. Contact housekeeping or maintenance staff when guests report problems.
• Make and confirm reservations.
• Issue room keys and escort instructions to bellhops.
• Keep records of room availability and guests' accounts, manually or using computers.
• Perform bookkeeping activities, such as balancing accounts and conducting nightly audits.
• Post charges, such those for rooms, food, liquor, or telephone calls, to ledgers manually or by using computers.
• Compute bills, collect payments, and make change for guests.
• Review accounts and charges with guests during the check out process.
• Transmit and receive messages, using telephones or telephone switchboards.
• Answer inquiries pertaining to hotel services, guest registration, and travel directions, or make recommendations regarding shopping, dining, or entertainment. Arrange tours, taxis, or restaurant reservations for customers.

• Greet, register, and assign rooms to guests of hotels or motels.
• Verify customers' credit, and establish how the customer will pay for the accommodation. Contact housekeeping or maintenance staff when guests report problems.
• Make and confirm reservations.
• Issue room keys and escort instructions to bellhops.
• Keep records of room availability and guests' accounts, manually or using computers.
• Perform bookkeeping activities, such as balancing accounts and conducting nightly audits.
• Post charges, such those for rooms, food, liquor, or telephone calls, to ledgers manually or by using computers.
• Compute bills, collect payments, and make change for guests.
• Review accounts and charges with guests during the check out process.
• Transmit and receive messages, using telephones or telephone switchboards.
• Deposit guests' valuables in hotel safes or safe-deposit boxes.
• Answer inquiries pertaining to hotel services, guest registration, and travel directions, or make recommendations regarding shopping, dining, or entertainment. Arrange tours, taxis, or restaurant reservations for customers.