Miyoshia Massey

Responded to telephone and email inquiries from members and providers, ensuring adherence to defined service standards.

· Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers.

· Assist members with benefits and healthcare questions.

· Document all calls received in system-based call log.

· Handle all incoming MedWatch precertification calls (i.e., start cases, do call logs, forward calls, provide case status, provide claims phone #’s, etc.)

· Make outgoing calls for MedWatch (demos, information for case completion, re-direction for network steerage, etc.)

· Complete incoming electronic Web-certs.

· Verify patient and provider demos – correct and/or complete when needed

• Educated clients on medication usage and safety guidelines.
• Managed prescription orders and ensured timely processing.
• Collaborated with healthcare providers to address patient needs.
• Assisted in resolving insurance coverage issues for medications.
• Maintained accurate records of patient interactions and prescriptions.
• Provided support to pharmacists in daily operational tasks.
• Received payment from customers for prescriptions filled or products purchased.
• Resolved insurance claims issues as needed.

• Provided personal care to clients, including bathing, dressing, and grooming.
• Supported clients in daily living activities and mobility to enhance independence.
• Coordinated medication schedules to ensure adherence to treatment plans.
• Engaged with clients and family members to discuss care needs and provide updates.
• Assisted clients with mobility issues by providing support for walking, transferring from bed to chair.
• Responded quickly and appropriately to emergency situations involving assigned patients.