Terra Davis

Allocating claims, determining policyholder's compensation and processing accordingly, splitting claims for wellness benefits, requesting medical records when necessary / routing claims ready for review appropriately, creating case items and routing when additional information is obtained, and understanding the differences between APIC and IHC underwriters.
Incident Claims Training (4/7/21) familiarized with incident claims / workflow.

Tier II Processor (06/03/21 - 01/10/22)
MR training (06/14/21) able to review claims which needed additional review for potential coverage concerns / making critical determinations for eligibility of claims, knowing when additional information is needing to be obtained / requesting additional information.
Prescreen Rotation (10/11/21) trained in dental claims which entail additional exclusions / review, familiarized with special claim conditions / extended waiting periods, routing claims to data entry vs allocation vs pending for additional medical records depending on the status of the claim, sending feedback to processors who routed claims to Pre-screen in error.
Partial Pay Veterinary Reimbursement Form claims (11/2021) trained in processing claims where net estimate is greater than the amount owed to the provider, requiring payment to be split up towards both provider and policyholder.

Tier III Processor (01/11/22 - present)
Confident processing without coaching, assisting lower tiered processors within Pre-screen with making determinations, intaking allocated incident and partial pay claims, manually entering in EOB using appropriate highlight tools in PDF doc, managing time appropriately between being the "Hype Dawg / Pawsitive Presenter" for the Desert Dogs (12/2021 - 06/2022) and assisting with "Who Let The Dogs Out" Desert Dogs Team board game / creating engagement events (06/2022).
(8/15/22) - 127 Underwriter Review trained.
(04/13/23 - 04/30/24 ) - provider calls within Appeals (APPADM)
(10/01/23 - 11/17/23) - coaching less tenured processors regarding when to request MRs on claims and how to best handle claim in question (MRPEND).
(11/20/23 - 12/28/23) T3 Assessment Proctor
(02/08/24 - 02/2024) Lead IHC Incident claim upskill trainer for processors / coaches
(02/25/24) "Deep Dive - Dental Claims" presentation for Desert Dogs Pack; created a in depth PowerPoint regarding each underwriter and their requirements for dental claims with snips of examples.

(04/01/24 – present) – mentor to less tenured claims processors in “Helping Paws” chat.
(06/07/24 - present) lead processor for the "Prescreen Triage Crew" providing updates, posting daily report numbers and providing Prescreen updates to front line leads.
(06/18/24 and 07/10/24) Assisted with updating dental documents within Genius (invoiced routine dental cleaning should be processed as wellness / MR request guidelines for dental claims across all underwriters).
(TBD) Dental Claims Shadowing for the Desert Dogs- in the process of setting up a time to schedule a shadowing with the team as I walk through dental claims for each underwriter.

Additional Awards
Top Dog: February 2021, June 2021 and December 2021

• Handling client interactions before the doctor meets client, calling clients to review treatment plans, discussing wellness plans in depth and discussing different plan options/possibilities that best fits client's/patient's needs, going over medications (purpose, administration and amount given) in person and over the phone, discharge instructions discussed with client before patient leaves clinic, filling medications in pharmacy, familiar with various medication requirements, administration and necessary testing (if needed), familiar with multiple tests required for diagnostic purposes, familiar with note taking via computer using SOAP format, ensuring duties are completed and satisfactory with assigned doctor and fellow employees, passing off cases if shift ends before patient has left to make sure quality of care is being met, comfortable working long hour days, multiple days in a row
• Surgical assistant recording vitals and maintaining safety of pet while under anesthesia / Surgical technician scrubbing in for surgery and assisting doctor with invasive surgery / Dental tech familiar with cleaning teeth, charting teeth and taking dental radiographs.

• Having extensive knowledge of products being sold throughout store, all around knowledge of pets being sold and going over care guides with customers, greeting customers as they walked into store, ensuring customer's questions have been answered and resolved any potential complications before they leave the store, upkeep of workplace environment and keeping work space free of debris or obstructions that could be hazardous or distracting, keeping an upbeat and friendly demeanor with customers, employees and supervisors, handling money and checking out customers at the register, completing tasks in a thorough and prompt manner, confirm that I have completed tasks that needed to be complete before leaving for the day.

• Greeting clients as they arrived, intaking pets and taking them to the back runs, answering phone with appropriate business dialog, logging pet into computer system, assisted with bathing, blow drying and trimming of various dog breeds, assisted with kennel husbandry.