Lisa Baptiste
Analyst- Government Programs
Willingboro,NJ
Overview
20
20
years of professional experience
Work History
Appeal Analyst GP
Horizon BCBS NJ
Newark, NJ
03.2016 - Current
- My duties include but are not limited to investigating and providing resolution for high level inquiries and complaints received by Medicare, Horizon BCBS NJ Executives as well as Government Officials and Agencies.
- Member and Provider issues related to Enrollment, Premium Billing, Sales/Marketing, Medicare Blue Claims and Pharmacy claim adjudication.
- Provided daily, weekly, and monthly reports that are used to provide root cause analysis and identify trending issues, retraining of Member Service representatives, implementing corrective action plans for existing policies and procedures.
Medicare Analyst II
Horizon BCBS NJ
Newark, NJ
04.2014 - 03.2016
Medicare Analyst I
Horizon BCBS NJ
Newark, NJ
03.2010 - 04.2014
Executive Government Appeals Analyst I
Horizon BCBS NJ
Newark, NJ
09.2008 - 03.2010
- Worked side by side with Horizon BCBS NJ Medicare compliance team to ensure Compliance with Medicare Advantage business operations.
- As well as providing timely resolutions to members and external customers who are experiencing problems outside of member services capabilities.
Member Service Associate
Horizon BCBS NJ
Newark, NJ
02.2005 - 08.2008
- Provided support for a fast-paced heavy volume call center.
- Processed enrollment applications and premium payments for Medicare Advantage, Sr. Billing and Enrollment.
- Provided resolutions for various types of member inquiries/grievances.
Timeline
Appeal Analyst GP
Horizon BCBS NJ
03.2016 - Current
Medicare Analyst II
Horizon BCBS NJ
04.2014 - 03.2016
Medicare Analyst I
Horizon BCBS NJ
03.2010 - 04.2014
Executive Government Appeals Analyst I
Horizon BCBS NJ
09.2008 - 03.2010
Member Service Associate
Horizon BCBS NJ
02.2005 - 08.2008
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