La Shawn Wise

*Specialty PM Billing and Revenue Cycle.

* Claim Submission Report

* Claim Exclusion Reports (Relay Health) / Claim Acknowledgment Report (Trizetto Provider Solution).ion)

* 997 Report-Batch Level and 227- Claim Level

* 997 Report- Batch Level and 377-Claim

* Level and ERA (Electronic Remittance Advice)

* Specialty PM Claim Payer Reports/Revenue Manager/Trizetto Provider Solution Site

* Correct claim in Specialty PM and Resubmit Claim from Specialty PM

Specialty PM-TriZetto

* Oversaw and executed comprehensive investigations for specialty practice claims.

• Conducted root cause analysis to minimize external intervention.

* Facilitated enrollment for claims and remittance processes.

• Access provider details and verify enrollment via designated sections in client’s platform.
• Determine enrollment requirement for claims by navigating payer list on child site.

* Handled all client communications concerning Specialty PM matters efficiently.

* Streamlined registration and scheduling procedures.

* Maintained precise data related to patient billing processes.

Streamlined workflows for accurate and timely insurance claim handling.

Conducted precise posting of payments made by patients and insurers.

reporting

• Processed patient payments and insurance reimbursements accurately.
• Enhanced accuracy in patient payment processing systems.
• Streamlined processes for configuring eligibility and benefit plans.
• Streamlined digital platforms to optimize patient payment processes.

Provided timely resolution to customer problems received via phone, ticket systems, and digital platforms.

• Captured log files, queried tables, and updated database fields to diagnose issues.
• Streamlined systems facilitating the processing of patient payments electronically.
• Diagnosed issues in front-end applications through information gathering, troubleshooting tools, and end-user shadowing.

• Respond to incoming calls using dashboards,emails or phones from customers needing troubleshooting on their cellular devices.
• Provide thorough support and problem resolution for customers.Troubleshoot cellular network, activation,and device issues for customers over the phone.
• Communicate effectively, professionally, and apply a positive customer service attitude in all forms of communication with internal and external customers.
• Document actions and resolutions.
• Work with customers having data connectivity issues.
• Meet and exceed Quality and customer satisfaction goals to ensure customer retention and uphold the company's brand by providing excellent service

• Process inbound and outbound technical support calls at a 20% faster rate than team average
• Researched issues on various computer systems and databases to resolve network complaints,answer inquiries,and outline solutions.
• Informed customers about issues resolution progress.
• Performs activations, network updates, backups and other cellular tasks.
• Provide assistance to domestic and international customers with network issues. Manage a high-volume workload within a deadline-driven environment.
• Handle 90+ calls daily, with duties including technical support, retrieving customer data, presenting relevant product information, and canceling services.

• Troubleshoot devices to fix network and Hardware issues
• Worked with customers having data connectivity issues
• Handled incoming calls and provide level 1 and 2 support of cellular device
• Multitasking by using several systems while creating two-way dialogue with your customer
• Worked service Desk