Angela Blake

• Support and capture all pertinent information from customers about their claims
• Conduct research and provide updates on status of new and existing claims
• Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim
• Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls
• Interact with colleagues on basic day-to-day issues, and network with supporting functional areas to create a seamless experience for the customers

• Provide in-depth intake analysis to Medicare and Medicaid participants to help define and execute against their long-term healthcare goals and objectives; act as a strategic partner and front-line advocate to help members comprehend the terms and conditions of their covered cost, outline out of pocket expenses and coordinate specialty care access across multiple providers
• Provide expertise claim support by reviewing, researching, investigating and processing claims as well as recovery and resolution for health plans
• Assist with escalated claims to resolve complex issues for team members and internal customers
• Review member claims for discrepancies, document findings as well as payments for reimbursements, when applicable
• Review guidelines as well as benefit plan documents and certificates to ensure proper benefits have been applied to each claim
• Support implementation of updates to the current procedures
• Ensure adherence to state and federal

• Process and route claims to appropriate associates for payment in a timely manner
• Make necessary adjustments to all Medicare claims
• Research codes, errors and warnings to resolve claim issues
• Completed basic training for all new system updates

Research and adapt to system changes

• Maintained accurate records of all customer transactions.
• Reviewed loan documents for compliance with applicable laws, regulations, and company policies.

• Prepped, sorted, indexed, imaged, scanned and filed confidential documents in secured appropriate location,

• Reviewed signed documents for accurate information and compliance with policies and proced
• Assisted customers with collateral research and copies of documentation/correspondence
• Assisted with storage, retrieval, and destruction of legal documentation
• Use product knowledge and review multiple systems to quickly analyze account situations. include, Hogan, Shaw, Clipr, ESO and EDM