Shevaugn A. Stewart

Processed pharmacy claims with accuracy and urgency for specialty medications while meeting and exceeding daily goal. Answered inbound calls from providers, patients and other departments with complex questions. Assisted team members in my role as a lead and also as a SME ( subject matter expert) assisting transitioning new agents from training.

Answered calls from providers and members regarding dental coverage. Calculated and verified deductibles, maximums, co-payments and coinsurance for resolving inquiries, facilitating adjustments, initiating extra contractual and reporting of any systems processing errors, overpayments and underpayments

Answered calls for consumers that want to enroll in health insurance through Affordable Care Act with Maryland Health Connection. Worked special projects as needed in different departments. Determined the eligibility determinations for consumers calling to get health coverage, Completed manual enrollments and send to the appropriate health carrier

Contacted customers regarding their deliveries

Handled any and all delivery issues from dispatch team

Searched for missing items in the warehouse

Created packets for drivers and assisted with anything else the delivery team may need

Answered inbound calls from members with complex questions regarding their health plan coverage

Assisted providers with billing, claims, authorization issues

Used Medco to help providers and members with the pharmacy portion of their claims

Contacted customers with charged off accounts to collect on past due bills.Made arrangements to pay off thru agreed settlements or payments in full. Skiptraced to locate customers that were identified unreachable. Faxed, filed and performed light administrative duties. Identified customers monthly that were eligible for suit and prepared them for the legal department. Met and exceeded monthly goals

Analyzed and resolved billing issues such as wrong meter reads, cancelled contracts, etc that were communicated by one of the collectors. Properly reviewed service contracts for each customer account and made necessary adjustments and, if needed, contact the customer to communicate and explain the resolution. Entered the credits into the OMD system accurately and timely. Created a spreadsheet for the CFO detailing the monthly debits and credits. Ran invoices and other reports nightly.Applied cash to accounts and processed lockbox payments