Regina Houston

• LOB: CSR Representative: Schedules veterans appointments, taking inbound calls and making outbound calls and speaking with providers concerning veterans appointments. Collecting veterans preferences for their appointments and documenting additional notes. Honor all appointments with veterans for covered services with an approved referral/authorization, Confirm eligibility and benefits by the approved referral/authorization, Check Cpt Codes in the SEOC Coding Systems, Update demographics, Fax referral/authorizations to providers for veteran services.
• LOB: Provider Services: Manage provider data, Gives credentialing statuses on provider’s contract request, If Netsub is direct with TriWest, Update demographics, Support telephone channel for healthcare providers and their staff to handle administrative tasks. Refer to specific, contracted medical or professional services delivered to patients or clients by authorized individuals or organizations.
• LOB: Claims Level 1: Checks claim status of a submitted claim and view remittances for the provider or 3rd party, Use the PGBA Portal to view the claim, Offer Self Service tools, Check Void and Reissue Request, Deliver detailed response on the claim. Transfer to level 2 for denied claims, reconsideration, recoupment and timely filing.

• Remote Prior Authorization Specialist/ WFH

verify insurance and benefits for patients prior to services being rendered, submit and process prior authorization requests for medications, procedures, and medical services through insurance portals and provider systems communicate with insurance companies, providers and patients regarding authorization status and required documentation, review medical records and clinical documentation to ensure accuracy and completeness for approvals, follow up on pending, denied, or incomplete authorizations in a timely manner, Maintain accurate documentation of all interactions and authorization updates in multiple systems, ensure compliance with HIPPA regulations and company policies while handling confidential patient information, Provide exceptional customer service while resolving issues related to authorizations and referrals, utilize electronic medical records (EMR), insurance portals, and multi-line phone systems to manage daily task efficiently .

• Maximus/ Data Processer/Fema - Raleigh, NC - Help families by taking incoming calls and entering their information into FEMA’s National Emergency Management Information System (NEMIS) and other FEMA approved databases. Provide timely responses to telephone inquiries in a courteous and professional manner, using pre- scripted responses, Follow policies and standard operating procedures such as filling out timesheets, adhering to privacy and HIPPA rules, Utilize standard technology such as telephone, e-mail, and web browser to perform job duties, Assist caller(s) with filling out online applications and submitting electronically to plan provider for processing, Complete basic call log related to the phone inquiries such as clicking radio buttons to confirm which scripts were read to the caller, Refer calls as required to CSR Lead, Maintain up-to-date knowledge of client regulations and policies, Report problems that occur via the online system so they can be addressed by the appropriate parties.

• Assist the installation team in the setup and installation of products and equipment according to established guidelines and specifications, Ensure that all tools, equipment and materials needed for installation are prepared and readily available, Collaborate with team members to safely and efficiently transport and handle products during the installation process, Follow installation instructions and diagrams to assemble and install products accurately and securely.
• Inspect and test installed equipment to ensure proper functionality and performance, Troubleshoot and resolve any issues or complications that may arise during the installation process, Communicate effectively with customers, addressing any questions or concerns they may have regarding the installation process, Provide exceptional customer service, maintaining a professional and courteous demeanor at all times.
• Maintain a clean and organized work area, both during and after installation, ensuring that all debris and waste are properly disposed of, Adhere to safety protocols and guidelines to prevent accidents and injuries during installation tasks, Document and report any product defects, damages, or issues encountered during the installation process, Collaborate with the installation team and other departments to streamline installation procedures and improve overall efficiency, Stay updated on industry trends, best practices, and product knowledge to ensure accurate and up-to-date installations.

• Respond to customer inquiries and request through various communication channels, including phone, email, and chat, while maintaining a high level of professionalism and empathy, Provide accurate and timely information about products, services, and policies to address customer inquiries and concerns, Assist customers in resolving issues, troubleshooting problems, and providing appropriate solutions, Actively listen to customers, demonstrating empathy and understanding, and take ownership of their concerns until a resolution is reached, Utilize company resources and systems to access customer account information, track orders, process returns, or perform other customer-related tasks. Process customer orders, payments, and returns accurately and efficiently, ensuring adherence to company policies and procedures. Collaborate with other departments, such as sales, billing, and technical support, to resolve customer issues or escalate them as needed.
• Maintain accurate and detailed customer records, documenting interactions and updating information in the customer database, Handle and resolve customer complaints or escalations in a professional and diplomatic manner, aiming to exceed customer expectations, Keep up-to-date knowledge of company products, services, promotions, and policies to effectively address customer inquiries, Adhere to established service level agreements, performance metrics, and quality standards while working remotely.

• Safely operates specialized, elevated lift trucks to pick, restock, and move inventory from high-level shelving. Include using RF scanners for inventory control, wrapping pallets, loading/unloading trucks, and strict adherence to safety protocols. Locate, pick, and transport items to accurately fulfill customer orders, Use RF scanners to scan products, track inventory, perform cycle counts, and report damaged goods. High accuracy in picking, scanning, and identifying products.