David Campbell

• Contracted through Ohio State University Wexner Medical Center.
• Complete daily screenings at patient bedside and by phone with limited supervision.
• File appropriate Medicaid and Marketplace applications.
• Collect, submit and follow-up on required documentation and pending applications.
• Enroll patients in ACA marketplace plans and obtain HFS documents for signatures.
• Provide guidance and support to patients throughout the insurance enrollment process.
• Assist patients in resolving any case issues with the Marketplace and Insurance Companies if they arise.
• Daily follow-up on all assigned accounts.
• Answer all emails and phone messages.
• Enter all information into HealthFund Solutions and OSU Hospital databases.
• Document and review patient information within the Electronic Medical Record (EMR).
• Participate in any required meetings and webinars.
• Provide any required screening or enrollment data for tracking of conversions.
• Responsible for placing calls for patient outreach.
• Other duties as assigned.

• Guide patients through the complexities of the healthcare system and help them find suitable primary care physicians and specialist doctors.

• Assist patients with updating coordination of benefits.

• Streamline the process for medical procedures by creating prior authorizations, pre-determinations, and inpatient notifications/admissions.

• Efficiently work under limited supervision in a cohesive team environment.

• Partner with third party administrators to ensure accuracy of claims status and prior authorizations.

• Review claims, plan benefit information and explanation of benefit statements with members and healthcare providers.

• Consistently achieve high weekly quality assurance monitoring scores.

• Consistently achieve weekly metrics for inbound/outbound calls, adherence, average handle time, average talk time & after-call work.

• Generated and assigned new claims accurately, ensuring timely follow up by product protection specialists.
• Thoroughly examined all e-mail and photo evidence for claim verification.
• Worked efficiently in a cohesive team environment with limited supervision.
• Handled customer complaints and escalated calls.
• Provided exceptional support to customers through the implementation of service objectives and the provision of value-added services.

• Accurately input insurance claim information electronically as needed.
• Attentively listened to customer description of auto glass damage and evaluated repair requirements.
• Engaged with customers, insurance agents, Area Sales Managers and/or National Commercial Clients.
• Leveraged partnership with the auto glass shops in order to secure appointments for auto glass repair/replacement.
• Collaborated with insurance companies to ensure accurate verification of customer's coverage and deductible.
• Demonstrated ability to meet guidelines for weekly KPIs in key areas such as average talk time, adherence, and successful wiper blade sales.

• Assisted in the training of new employees.
• Assisted in creating job aides and implementing new team policies and procedures for increased efficiency.
• Facilitated effective communication between corporate, vendors, and retailers to ensure efficient execution of dispatch and follow-up tasks.
• Collaborated with Client Service management on key project decisions.
• Facilitated communication between vendors and technicians, ensuring timely dispatch to commercial properties.
• Provided intelligent and responsive support to ensure proper resolution of facility maintenance needs/requirements for commercial properties.
• Consistently achieved and maintained excellent quality assurance monitoring scores on a weekly basis.
• Consistently achieved weekly KPIs for average talk time, and calls per hour.