Michelle Dobbs

When I started working for the company in 1994 I was hired into the mailroom to sort claims, correspondence, payments and appeals. Within a few months I was promoted to claims processing of medicare claims for multiple groups on different systems for HMO, PPO and Indemnity networks. I lead the way to train a new system for claim processing, Proclaim paved the way for faster processing and quality assurance. I worked in claim processing for 7 years. Moved on to quality auditor, appeals/correspondence, eligibility, provider contracting and my last position as a business analytics lead analyst. In this position I was part part of the delegated credentialing roster team.

Responsibilities include but not limited to high functionality in network and contract manager system. Utilize programs to run reporting for updated provider contract and data information. Experienced in multiple processing claim systems, market guidebooks, federal and state laws, cognos reports, credentialing applications, excel and word documents. Research data and analyze all information that is pulled from reporting systems. Send reports to designated areas fro updates. Loaded contracts into systems. Identified errors in contracts, credentials and maintain relationship with contract manager as things arise. Strong communication skills, networking, ability to learn on the fly, dealing with ambiguity, collaboration as a strong team player and identify with problem solving.

In this position I had many jobs. Daily we would take calls for the pharmacy and store questions. Fill out insurance information in the system for prescriptions that needed to be filled for the pharmacist. Make calls to the insurance companies for verification. We helped label prescriptions after the pharmacist would verify the prescription. We faced the pharmacy area and rang up the customers.