Michael Johnson

Examine incoming documents and keep comprehensive records of all providers, making necessary modifications and additions to the provider records within the existing claims processing system. Update records in accordance with network and governmental regulatory standards.

• Ensures the accurate and timely updating of provider records within the existing claims processing system to modify and incorporate data. This encompasses, but is not limited to, provider names as registered with the IRS, addresses, generic names, and Federal tax identification numbers.
• Engages with providers and corporate offices via telephone to gather essential information required for the completion of provider files.
• Conducts investigations into the various provider tax identification numbers, parent companies, primary locations, physical addresses, billing services, and names registered with the IRS to ascertain the correct departmental procedures and implement necessary modifications.
• Reviews and revises specific additions, changes, and terminations within the PPO network and proprietary network based on slice reports provided by the Provider Network Management department and other proprietary networks.
• Collaborate with supervisors, the Provider Network Management Department, the Provider Relations Department, and provider office staff concerning inquiries or urgent changes.
• Inputs new proprietary network providers and fee schedules derived from provider applications.
• Updates provider information based on Macess service forms received from the Provider Network Management Department.
• Prepares and scans documents promptly.

• Providing support to members and providers regarding claims information.
• Generating and distributing service forms containing the requested details to guarantee timely processing and payment of claims.
• Collaborating with clients to enhance their understanding of their benefits information.

• Initiate communication through inbound and outbound calls to engage with borrowers who have overdue accounts, while assessing their financial circumstances to provide optimal repayment options.
• The customer service position is categorized on a scale from 1 to 5, with my current designation being level 4.
• Beyond my standard responsibilities, I frequently assist in training new staff members.
• Additionally, I am equipped to handle escalated calls from my supervisor on a regular basis.

• Responded to both inbound and outbound calls concerning customers' credit card accounts.
• Employed my problem-solving and decision-making abilities to ensure optimal customer satisfaction.
• All details from each call were recorded in a central database.

• Checking out customers
• Assisted customers with their selections and product needs
• Wrapping customers merchandise as needed
• Stocking
• Working in Receiving
• Customer Service.

• Cashiering
• Stocked shelves with music (CD’s) and other items throughout the store
• Rotated and organized merchandise
• Maintained store environment via vacuuming and dusting of general areas
• Assisted customers with merchandise/sales.