Celeste Joseph

Analyze encounter data to identify trends, patterns, and anomalies for the health plan.
• Generate comprehensive reports and insights from encounter data, supporting business process.
•Conduct thorough analysis on designated projects, resulting in the successful recovery of funds for the health plan.
Create claims projects to recoup money for the he
•Investigate and resolve encounter data discrepancies or issues, collaborating with claims team, corporate encounters team, and state.
•Research regarding provider and members state rejected encounters issues and finding resolutions to provider NPI and taxonomy issues.
•Analyze and document existing business processes, identifying areas of improvement and recommending solutions that led to an increase in team productivity.
•Initiate and lead claims projects aimed at recovering funds to identify and rectify discrepancies, overpayments, and erroneous claims for the health plan.

• Diligently manage and update member account data through meticulous processing of manual forms and timely updates of digital information.
  •Conduct thorough assessments of caller accounts to ascertain Medicaid benefits, identify service requirements, and proficiently resolve issues.
  •Consistently meet and exceed customer call guidelines, ensuring adherence to service levels, handle time, and productivity metrics.

• Enhanced productivity by staying on top of call scripts and maintaining control over direction of conversations
• Met established attendance expectations and team revenue goals to achieve company objectives
• Documented and verified patient data via Excel.

• Recommended type and amount of coverage based on analysis of customers' circumstances using persuasive sales techniques
• Conducted research on insurance packages and investment options to generate client recommendations
• Approached potential clients by using direct marketing techniques, including mailings and phone contacts.

• Managed closing duties, including restocking items and reconciling cash drawer
• Recorded orders and partnered with team members to efficiently serve food and beverages.

• Collaborated with store manager to develop successful strategies for achieving sales and profit goals
• Produced monthly sales and performance reports, supporting operational planning and strategic decision making
• Secured revenue, accurately monitoring transactions and deposits to eliminate discrepancies.

• Directed clients to appropriate personnel to address concerns, resolved complaints or answered account-related questions
• Sorted and distributed business correspondence to correct department or staff member, reducing dropped communications and enabling faster responses to key requests
• Prepared, compiled and filed documents as well as reports presented to various parties.