Andrea Sweeney

Act as a liaison between insurance companies & providers, obtain missing info such as patient demographics, Rx, diagnosis, insurance & claim information, schedule MRI, Ultrasound, CT, Myelogram, Arthrogram & XRAY exams in a timely manner. Obtain and/or verify authorization or reasons for denial. Update files with pertinent information as it pertains to injured worker. Communication with NCM, Adjuster and/providers

Create new referrals and work existing referrals

• Reviewed, investigated and corrected errors and inconsistencies in financial entries, documents and reports.
• Managed payroll and time and attendance systems.
• Responded to employee inquiries regarding payroll and timekeeping.
• Troubleshoot Etime & MyPay errors & verify information in SAP
• Responsible for rapid & efficient resolution of routine requests for support & payroll escalations
• Performs record keeping and clerical functions such as scheduling, faxing, emailing, data entry & follow up

• Provided assistance to plan participants by explaining benefits information to ensure educated selections.
• Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to medical, dental, life insurance, flexible spending & retirement benefits.
• Process new hire and open enrollment elections

Coordinates & directs all service activity requests with field engineers, ensure that appropriate records are established & maintained in Remedy & Southware systems. Manages caLL queue for new & unresolved tickets, drives call flow to meet SLA percentage, assign appropriate field manager to service call, provide update to customer on progress of service, performs call escalation according to procedure, gather required closing information from field manager regarding actual repair activity, implement customer satisfaction to maintain existing business & customers