Maureen Dougherty

- Develop and maintain relationships with healthcare providers to ensure alignment with organizational goals and objectives.

- Analyze provider performance data and collaborate with internal teams to implement strategies for improvement.

- Conduct regular meetings with providers to address concerns, provide updates, and identify opportunities for collaboration.

- Collaborate with cross-functional teams to streamline communication and enhance provider satisfaction.

- Lead training sessions for providers on new tools, processes, and initiatives to improve engagement and compliance.

- Manage and process a high volume of insurance claims, ensuring accuracy and compliance with company policies and industry regulations.

- Conduct comprehensive investigations to validate claims, collaborating with relevant stakeholders to gather necessary information.

- Communicate effectively with policyholders, providing updates on claim status and addressing inquiries to ensure a positive customer experience.

- Collaborate with underwriters and legal teams to resolve complex claims issues and streamline claims handling processes.

- Utilize claims processing software to maintain detailed and accurate records of claims transactions.

- Verify insurance coverage for patients by reviewing insurance details, policy terms, and eligibility criteria.

- Communicate with insurance companies to confirm policy information, coverage limits, and pre-authorization requirements.

- Collaborate with healthcare providers and billing teams to resolve insurance-related issues and ensure accurate billing processes.

- Maintain detailed and up-to-date records of insurance verifications, authorizations, and communication with insurance providers.

- Educate patients on their insurance coverage, co-pays, and any out-of-pocket expenses.