Emily Berkman

- Execute prior authorization submission. Ensuring coverage eligibility and resolving complex issues promptly.

- Utilizing cover my meds platform to ensure a smooth prior authorization process.

- Monitored the status of prior authorization requests to make sure the member is taking care of.

- Crossed trained in progression que.

• Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
• Followed up with customers on unresolved issues.
• Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
• Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
• Reviewed, researched and processed short term
  disability, FMLA, and ADA claims. Maintained and
  exceeded company goal of 25 claims per day.

• Maintained strict confidentiality with all personal data as per company guidelines.
• Viewed reports regularly to make sure processing was conducted efficiently.
• Examined claims forms and other records to determine insurance coverage.
• Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
• Identified insurance coverage limitations with thorough examinations of claims documentation and related records.

• Took over 100 calls per day over via phone to book reservations and provided excellent customer service.
• Resolved guest complaints and discrepancies in prompt and courteous manner.
• Responded to guest inquiries, complaints and special requests to increase customer satisfaction.
• Collaborated with team members to handle guest requirements from check-in through check-out.
• Took reservations over phone and through email, recording guest information in computer system and verifying details.

• Followed up with customers after completed sales to assess satisfaction and resolve technical or service concerns.
• Generated Sales through weekly phone calls to accounts with a base of 150 clients and up selling whenever possible.
• Promoted new products and services to existing customers, driving revenue growth and satisfaction.
• Informed customers of sales and promotions to build customer base, boost traffic and increase customer loyalty.
• Advanced quickly moving up 3 ranks within the company.