DIANA T.

Scheduler appointments for incoming calls for neurosurgery. Answer questions from neurosurgery patients, providers, agencies, referrals, and fax outbound medical information to providers. Create referrals. Make outbound calls to patients, hospitals, other providers, reschedule appointments, send and respond messages to doctors or clinical staff, fax referrals to other providers or facilities.

Caregiver for patients with dementia, anxiety, respite, and other psychological or medical disorders with cooking, feeding, bathing, toiletry, medication aide, shop for groceries, medications, cleaning house, companionship time with the patient.

Caregiver for patients with dementia, anxiety, respite, and other psychological or medical disorders with cooking, feeding, bathing, toiletry, medication aide, shop for groceries, medications, cleaning house, companionship time with the patient.

Receive incoming calls for customers with returns, purchases, inquiries for items of clothing, shoe apparel, and other items pertinent with Sportswear sold within the company.

Key in PBV applications and application updates into Yardi system for applicants. Answer incoming calls for Housing department and transfer to appropriate employee. Go through voicemails for housing department and transfer to appropriate housing employees. Tend to applicants, tenants, landlords, etc who come into housing reception area for assistance with questions, copies, turn in paperwork for Occupancy specialists, etc. Call to Occupancy specialists for assistance with tenants wishing to speak to or assist during Wednesday Walk In. File applications and updated applications into filing shelves waiting lists for applicants. Receive and distribute mail to appropriate occupancy specialists, accounting, administrative assistants, or managers. Setup lottery voucher waiting listings, send packets to applicants, audit packets received, communicate via email, telephone, in person with applicants on items missing. Setup briefing meetings for applicants and conduct them. Follow-up with applicants if no reply to packets with denial letters and then file to archives.

Work on excel spread sheets with Centene software for updating provider data through various methods including public websites, claims status and online contracting. Work excel spreadsheets for different provider listings and plans. Update contracts through various software systems for payment processing and directory listing. Outgoing calls with providers/hospitals for updated licensing/NPI information. Create authorizations for Skilled Nursing Facility, create inpatient authorizations for hospitals, call hospitals/providers for updated information of patient per authorization request.

Make outgoing calls and or receive incoming calls from members or other departments from Superior Health plan for appointment setup through Trucare launch pad FSM 2 calendar or Outlook scheduler for appointments with LVN/RN for Star kids or Star plus. Verify and identify PHI/HIPAA information of member and probe for available dates/times for assessment Face to Face with Care Manager. Read notes in Trucare summary, or Authorizations to evaluate type of assessment needed. Talk to members or LARS concerning information of member status, PCP information, authorization status, assessment status, screening status and transfer to proper department for other assistance not provided. Manage traveling distance and time for Care Managers between member visits in region through launch pad, Batch Geo or Google map. Setup ARF letters for a vendor within certain regions for assessments for DAHS/PAS Waiver upgrade, Bi-Annual, Quarterly, Address provider, agency needs by providing information through various software programs and input in system for recording on member/provider account. Research closing accounts from spread sheet and apply closing remarks, after research member eligibility, authorization on file, notes from previous employees. Work on 2065D, 2067 excel spreadsheet reports with closing member account after thoroughly researching different documentation before closing permanently member account, e.g., (for example), member expire, member not qualify or eligible through DADS.

Answer incoming phone calls from clinic patients, clinic staff, update insurance information and file HCFA paper claims and/or through electronic submission. Appeal insurance claims with medical record documentation, submit supplement, or secondary insurance claims, and call medical insurance for research in patient accounts. Retrieve medical records to submit to attorneys. Research Medicaid/Medicare/Tricare patient accounts through via Web page and/or telephone to commercial, BCBS, HMO, PPO, MHMO, PHCS insurance companies. Submit corrected ICD-coding diagnosis/modifiers for appeals to insurance with medical documentation or without. Key in request of denials, deductibles, adjustments, for patient accounts Submit corrected charges using CPT coding. Research patient bad addresses via phone to hospital, doctor's office, the Bexar county directory, and through internet software. Research bankruptcy and collection accounts.

Answer incoming phone calls from laboratory patients, take insurance information and file HCFA paper claims and/or through electronic submission. Appeal insurance claims with medical record documentation, submit supplement, or secondary insurance claims, and call medical insurance for research in patient accounts. Retrieve medical records to submit to attorneys, ,and assist with notary public document. Research patient bad addresses via phone to hospital, doctor's office, the Bexar county directory, and through internet software. Research bankrupt and collection accounts.Key in insurance payments, patient payments, adjustments, denials, and deductibles in patient accounts. Submit credit card payments via credit card machine. Research unidentified payments; send information to insurance, and patient requesting additional information via mail, and/or telephone. Submit payments for Blue Cross Blue Shield/Medicare through ERA system. Medicaid, Medicare, Tricare, MHMO, HMO, PPO, COMM, PHCS. Research Medicaid/Medicare/Tricare patient accounts through via Web page and/or telephone to commercial, HMO, PPO, MHMO, PHCS insurance companies. Submit corrected ICD-coding diagnosis/modifiers for appeals to insurance with medical documentation or without. Key in denials, deductibles, adjustments, and insurance information in patient accounts. Submit corrected charges using CPT coding. Answer multi-line telephone system, and direct to correct extension.