HARSHA C NAIK

• II provides timely and effective sales administrative support to assist with the acquisition or retention of customers.
• The Sales Agent Support Representative II performs varied activities and moderately complex administrative/operational/customer support assignments.
• Performs computations.
• Typically works on semi-routine assignments.
• Benefits verification - Medicare - LIS check, Medicaid - Disability / Dual Eligibility and Private Insurance coverage verification.
• Providing timely and effective sales support to Humans Medicare selling agents.
• I handled a high volume of inbound phone calls to assist insurance agents with Medicare enrollment inquiries including the following: agent compliance (contracting, licensing, and certification), member enrollment, and agent commissions.
• Received inbound calls from internal and external selling agents in a fast-paced call center to aid with enrollment inquires (contracting, licensing, member enrollment, agent commissions etc.).
• Provided compliance verification, submission/confirmation of contracts, licenses, and certifications.
• I researched and resolved inquiries from Medicare field agents, involving member enrollment and company products.
• Establish rapport & strengthen relationships with internal and external Medicare field agents.
• Educate and engage callers on a variety of resources allowing them to explore solutions to achieve their goals and member well-being.
• Used on line Chat with Sales Agents.
• Build Humana’s brand by providing perfect experiences.

• Provides customer service to hospital patients who have questions on their accounts and assist them in settling their account balances.
• Handle inbound calls from patients as well as make outbound calls to patients.
• Assist patients with their account, which includes setting up payment arrangements; taking payments over the phone; identifying and gathering new insurance information, screening for charity, answering patients’ questions, and resolving any of the patients account issues, etc.
• Maneuver between several different software systems.
• Clerical duties, such as processing mail, light skip-tracing.
• Verify insurance and follow-up with pending insurance.
• Maintain accurate and up to date information in the account.
• Always maintain confidentiality of account information.
• Adhere to the prescribed policies and procedures as outlined in the Employee Handbook and the Employee Code of Conduct.
• Maintain awareness of and actively participate in the Corporate Compliance Program.
• Assist with other projects as assigned by management notes.
• Meet specified goals and objectives as assigned by management on a regular basis.
• Explain COB, how their Insurance covered the charges.
• Assist and explain as to why a service / claim were denied.

• The PSR responsibilities include, but are not limited to the following: The Patient Service Specialist is responsible for investigating and as applicable to obtaining accurate major medical and pharmacy insurance benefits for patients for whom we have received a benefit request or program enrollment.
• Performing patient level benefits verification as applicable for all major medical - Medicare, Medicaid and Private Insurance Carriers.
• Accurate documentation of benefits in the Patient Plus system.
• Completion of the template forms that provide patient level benefits Coverage Determination Summary, as applicable.
• As applicable, coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance.
• Patient Assistance Qualifications.
• Review of patient assistance enrollment forms and any supporting documentation to assess patient eligibility for participation as per SOP's and program guidelines.
• Determination of patient’s eligibility and refer to Foundations for assistance with Co pay, Out of Pocket Max and Deductibles based upon program criteria for qualification.
• Communication of patient’s eligibility to patient based upon program criteria for qualification.
• Communication of patient’s eligibility to the respective consignment pharmacy.
• Reporting of Adverse Events/ Product Complaint inquiries received in accordance with SOP and good manufacturer practices.
• Make Provider Welcome Calls.

Sales Agent Support Representative II provides timely and effective sales administrative support to assist with the acquisition or retention of customers.
• The Sales Agent Support Representative II performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
• Providing timely and effective sales support to Humans Medicare selling agents.
• I handled a high volume of inbound phone calls to assist insurance agents with Medicare enrollment inquiries including the following: agent compliance (contracting, licensing, and certification), member enrollment, and agent commissions.
• Received inbound calls from internal and external selling agents in a fast-paced call center to aid with enrollment inquires (contracting, licensing, member enrollment, agent commissions etc.).
• Provided compliance verification, submission/confirmation of contracts, licenses, and certifications.
• I researched and resolved inquiries from Medicare field agents, involving member enrollment and company products.
• Establish rapport & strengthen relationships with internal and external Medicare field agents.
• Educate and engage callers on a variety of resources allowing them to explore solutions to achieve their goals and member well-being.
• Build Humana’s brand by providing perfect experiences.

• Direct contact with importers to obtain essential information needed for customs clearance.
• Follow up throughout the day to obtain needed information for clearance.
• FDA Processing with all Shipments.
• Systems knowledge of BOSS, ISPSYS, BDIS, IDIS.
• Knowledge of VLM Special.
• Knowledge of Harmonized Tariff Schedule of United States Customs.
• Run completed work reports at end of shift.
• Secure pertinent details on importing commodities.
• Contact U.S.
• Consignees via e-mail and telephone communications.
• Possess thorough knowledge of U.S.
• Importing requirements and the ability to gain this information by using extensive resources.
• Make mathematical calculations and ensure proper questions are posed to the consignee and/or shipper regarding origin functions values and the end use of the goods being imported.
• Advise importer of customs charges and additional UPS charges when applicable toward clearance of goods requiring special attention.
• Fish and Wildlife agriculture marking, Food and Drug submissions and to complete all required forms and declarations as required by law.
• Prioritize work to meet port specific deadlines.
• Document packages being held on proper hold lists.
• Able to work within tight time constraints and can handle stressful situations.

Clearing International Shipments /Multi- National Accounts.
• Direct contact with importers to obtain essential information needed for customs clearance.
• Follow up throughout the day to obtain needed information for clearance.
• FDA Processing with all Shipments.
• Systems knowledge of BOSS, ISPSYS, BDIS, IDIS.
• Knowledge of VLM Special
• Knowledge of Harmonized Tariff Schedule of United States Customs.
• Run completed work reports at end of shift. Secure pertinent details on importing commodities.
• Contact U.S. consignees via e-mail and telephone communications.
• Possess thorough knowledge of U.S. importing requirements and the ability to gain this information by using extensive resources.
• Make mathematical calculations and ensure proper questions are posed to the consignee and/or shipper regarding origin functions values and the end use of the goods being imported.
• Advise importer of customs charges and additional UPS charges when applicable toward clearance of goods requiring special attention.
• Fish and Wildlife agriculture marking, Food and Drug submissions and to complete all required forms and declarations as required by law.
• Prioritize work to meet port specific deadlines.
• Document packages being held on proper hold lists.
• Able to work within tight time constraints and can handle stressful situations.

The Patient Account Representative provides customer service to hospital patients who have questions on their accounts and assist them in settling their account balances.
• Handle inbound calls from patients as well as make outbound calls to patients.
• Assist patients with their account, which includes setting up payment arrangements; taking payments over the phone; identifying and gathering new insurance information, screening for charity,
• answering patients’ questions, and resolving any of the patients account issues, etc.
• Maneuver between several different software systems.
• Clerical duties, such as processing mail, light skip-tracing.
• Verify insurance and follow-up with pending insurance. Maintain accurate and up to date information in the account.
• Always maintain confidentiality of account information.
• Adhere to the prescribed policies and procedures as outlined in the Employee Handbook and the Employee Code of Conduct.
• Maintain awareness of and actively participate in the Corporate Compliance Program.
• Assist with other projects as assigned by management notes.
• Meet specified goals and objectives as assigned by management on a regular basis.
• Explain COB, how their insurance covered the charges.
• Assist and explain as to why a service / claim were denied.

• Members inquiries are of basic and routine nature.
• Benefits verification - Anthem, Medicare and Medicaid.
• Addressed Member question through on line chat.
• Document and track contacts with members, providers and plan sponsors.
• Answer questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors.
• Handle member, providers inquiries and problems via telephone, internet, chat or written correspondence.
• Process complaints (member/provider), grievances and appeals via company system.
• Educate members and providers on the self-service options.
• Triage resulting rework to appropriate staff.
• Explain and educate members of their responsibilities and rights in accordance with benefits / contracts.
• Determine applicable coverage provisions and verify member plans, coverage, eligibility, deductibles and accumulations to members.
• Handle incoming requests for appeals and pre-authorizations, pre-certifications handled by UM, Aim and Clinical Management.
• Explain claims/ billing codes to members and forward to appropriate departments for reprocessing and adjustments.
• Be an advocate for our members with providers and prescription vendors.
• Active Participant in resolving provider and member / patient disputes.
• Meet daily/weekly/monthly inbound and outbound call requirements.
• Applicable system tools and resources to produce quality letters and spreadsheets.

• Responsible for all Transactions.Keeping all logs in compliance of FDC rules and regulations.
• Promote PNC product / promotions to current, new and Business clients.
• Excellent written/oral communication skills, exceptional analytical skills, and good with numbers and problem resolution.
• Effortlessly able to establish relationships with Business clients.
• Maintaining a Five Star Gallop.
• Responsibility of two ATM machines – unload verify the count and reload.
• In charge of safety deposit boxes and logs.
• Responsible for collecting cash drops boxes ATM machines.
• Responsible for collecting cash drop bags deposits.
• Adheres to company count policies and procedures and various regulatory requirements.
• Records cash activity electronically from ATM machines.
• Supplies related paperwork to Revenue Audit Team.
• Verifies each day’s bundles and strapped currency on scope basis.
• Responsible for Safe Deposit Boxes in compliance with regulations.
• Ordering currency US Dollars (for Bank) and Foreign Currency.
• Opening accounts – Checking and Savings.
• Helping Customers with CD Rates, Loan rates…….
• Closing and Opening the bank following all security procedures.