Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities. Knowledgeable Eligibility Representative with history of assessing and verifying client eligibility efficiently. Successfully managed case documentation and resolved complex client inquiries. Demonstrated strong communication and problem-solving skills, ensuring high levels of client satisfaction.
Verify Eligibility PPO, HMO Medical benefits, generate estimates for patients copays and deductibles, verify by contacting Dr. offices correct and proper Cpt codes for Surgery Scheduling and obtaining Surgery authorizations and Worker Comp Information , deal with daily phone calls from Patients and Dr. offices , make daily contact calls to Health Insurances with any corrections and benefits changes.
Received all Enrolment applications, stamped date and sorted all mail scanned under Eligibility mainframe , entered all member Eligibility to process and approved benefits , answered daily calls from Providers Inquiring Information to accept the patient to their Facility , dealt with different Departments in regards to filed documents and active benefits to process proper billing.