Call Center executive
Pentacare Medical Services
مجموع سنوات الخبرة :10 years, 6 أشهر
• Gathers and process all the information needed to complete the medical insurance claims.
• Taking inbound costumer service calls and making outbound calls to the patients and healthcare providers.
• Analyzing all information gathered before giving approvals or rejections accordingly on every claim with prior consultation to the pre-approval manager.
• Monitoring the limits of each member’s before giving approval for a particular claims such as the preexisting limit, chronic limit, pharmacy limit etc.
• Refers questionable claims to the manager, investigating pending claims and resolve discrepancies.
• Proficient in processing medical claims using the Aman Insurance System Software, familiar in using ICD’s & CPT codes and online prescriptions thru PBM Software provided by MedImpact.