Leslie Saucedo

Assist the Manager/Supervisor in identifying root cause issues related to appeals. Responsible for maintaining and prioritizing work load to support appeal timeliness and communicate risks, concerns or opportunities to leadership related to their work load.

• Reviewed medical records for accuracy prior to submitting an appeal decision.
• Facilitated communication between members, providers, internal departments, and external organizations regarding appeals inquiries.
• Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.

As a member of the team, I was responsible for providing support to business operations such as front end, image & data capture, and / or document / transaction content management.

• Participated in training and other learning opportunities to expand knowledge of company and position.
• Identified data entry errors and corrected mistakes to achieve near-perfect accuracy in data sets.
• Interacted with customers to determine their needs and provided information about products and services.
• Translated written documentation and notes into emails and other types of correspondence.