case management executive
Metlife alico
Total years of experience :11 years, 2 Months
Exceeded the 100% claims rate target up to 35% and prepared detailed, accurate savings reports for review by upper management.
o Provided optimum reviews, analysis, and approval for OP and IP services, leading to a 40% boost in quality patient care ratings.
o Achieved a 100% success rate in developing and executing outreach and relationship-building plans
o Achieved a 100% success rate in claims collection, verification, and transfer to the TPA.
o Supported and mentored staff members in resources, standards, data, and contacts to drive improved team and company performance.
o Delivered top-level customer service by reviewing claim submissions in order to properly determine eligibility and level of coverage
Achieved 130% of annual sales targets by developing and implementing effective sales strategies.
o Increased revenues 55% by effectively communicating current promotions, payment policies, exchanges, and security practices.
o Resolved customer issues with the highest professionalism and integrity to ensure 100% customer satisfaction and boost retention 40%.
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Masters in business Admin
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