JOAN NAGY

* Administered PPO Claims for Medical, Dental, Vision & Hearing

* Provided appropriate Customer Service through personal,

Telephone, Written correspondence to Insureds, Agents, Providers

of service & Other Insurance Carriers

* Performed necessary Claim Adjustments & Re-issues

* Reviewed Utilization thru Pre-certs & other records to determine

insurance coverage

* Administered PPO Plans for Medical, Dental, Vision, Hearing &

Disability

* Viewed Reports regularly to make sure processing was completed

efficiently

* Reviewed Injuries to determine Plan of Action through Letters,

Er Reports & Police Reports

* Reviewed Utilization thru Pre-Certs & Other records to determine

Insurance Plan Coverage

* Responsible for answering Telephone calls from Agents, Insureds &

Providers

* Gave Benefit Information specifics within American Community

Plans

* Investigate and determine Claim processing Issues & forward for

Adjustments

* Investigate and determine Plan Issues & forward for resolution

* Daily & Monthly Censes Reconciliation

* Responsible for Medicaid Billing & posting payments

* Assisting & Completing Medicaid Applications with Responsible Parties

* Compile Daily Deposits

* Reconcile & Monitor Resident's Trust Accts

* Audit and Adjust Resident Accts