Maria Mccormick

Auto Customer Solutions (Promoted 4/2004-Present)

• Handle inbound and outbound calls from a dialer in a timely manner, working closely with clients to understand their reason for delinquency. Offer suitable alternatives, such as Repayment Plan, Modification, or Extension, to help resolve delinquency.
• Respond to customers' inquiries, verify and research payments, process payments by phone, generate payoffs, generate demand letters, and potential repossession loss while adhering to all state and federal laws.

Consultant Customer Deposits (12/2022-3/2024)

• Consult and collaborate with departments to determine proper account resolution, to avoid and reduce future business and client impact.
• Create and send various fulfillment documents to customers. Serve as a primary contact for the resolution of account maintenance transactions.
• Respond to research cases for Premier accounts through extensive research into multiple customer profiles to determine the needs on wire verification transfers, while managing IRA, Trust, Premier, and basic troubleshooting and all types of Ally Deposits Accounts.

• The first point of contact for our policyholders, explaining the claims process, timeframe for processing LTD, STD, and FMLA.
• Initiate claims according to best practices, as assigned, and provide exceptional customer service.
• Maintain composure and direction in high-pressure situations.
• Develop and enhance your communication skills to meet the customer's needs, while demonstrating empathy, flexibility, responsiveness, and an action-oriented approach.
• Develop critical thinking and investigative techniques to issue spot, identify resources needed to assist in making claim determinations, while applying factual information provided by the customer to the policy to assess eligibility.

• Processing and adjudicating member/provider submitted paper claims for our line of business
• Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures
• Accurately resolving pending claims using state and federal regulations and specific health plan criteria
• Working within turnaround times to meet client performance guarantees for claims processing
• Meeting productivity and accuracy standards
• Team-oriented while also able to pursue personal and departmental production goals daily

• Utilize the Multi Carrier System, Quality Management System and Medicare Appeals Processing System
• Evaluate Medicare Part B claims to determine medical necessity
• Adjudicate Medicare Part B claims and whenever necessary, resolve edits and audits that suspend during the adjudication
• Provide accurate, timely, courteous and personable customer service to Medicare Part B providers and beneficiaries
• Identify potential aberrances, including fraud and abuse of the Medicare program in accordance with CMS rules and regulations
• Identify, research, and analyze training, development and quality issues
• Complete special projects as assigned