Responsibilities and Duties:
• Provide personalized customer service and assistance to assigned set of groups
• Direct groups and brokers to carriers for claims and payment processing issues
• Resolve eligibility and basic billing inquiries received from assigned set of groups
• Document and coordinate all requested plan level changes from groups (i.e., plan changes, wait period, renewed changes)
• Document and keep accurate and detailed notes of all correspondence with group and broker
• Work with leadership and Senior CSR to escalate complex eligibility and billing issues to the carrier(s) for resolution
• Promote value add products and marketing campaigns to groups and brokers as necessary
• Build relationships with the main contacts for all large groups (50+ members) within their assigned set of groups to provide additional personalized service focused on group retention
• Answer all incoming call and chat requests through the general hotline phone queue and chat software
• Manages exceptions, determines eligibility holds, runs self-bills* and past due accounts

Customer Success Representative

Responsibilities and Duties:
• Meeting and exceeding department goals
• Demonstrate ability to interact and communicate effectively with sales department, providers, and patients.
• Processing orders and providing general details about product details to providers and patients
• Responsibilities:
• Provide exceptional client service to existing clients, offices, and clinics through outbound calls, being responsive to requests, identifying needs and offering solutions to program issues
• Make sure that the information that I am providing is accurate and correct
• Follow up with on requests and questions in a timely matter
• Assist and implement company policies, procedures, and guidelines

Customer Service Representative

Responsibilities and Duties:
• Provide exceptional patient care
• Scheduling Patients
• Communicate insurance information to appropriate parties
• Verify insurance benefits and eligibility
• Obtain Prior Authorizations
• Collecting Payments
• Answering Phone
• Assisting Physical Therapist with patient care

Front Office Coordinator

Achievements.
• Providing excellent customer service and maintain a high-level service to brokers, groups, and members
• Provide clear and explicit documentation
• Achieve productivity goals and resolving issues in a timely and efficient manner

Responsibilities and Duties:
• Handles calls from customers to resolve, educate, follow-up and respond to questions regarding CaliforniaChoice plan administration and procedures
• Educate brokers, groups, and employee's via telephone about Doctors, ID cards, RX problems, administrative procedures, dependent coverage, address changes, and benefit information
• Follow-up calls from brokers regarding problems that their groups are groups and employees are experiencing
• Responds to calls from providers about eligibility and benefits
• Verify enrollments, benefits, and resolve claim issues
• Expedite processing of enrollment and eligibility issues for employee's

Achievements:
• Established and maintain a high level of patient and physicians satisfaction through daily interactions and exceeding daily productivity
• Leading the authorizations team and troubleshooting, possible discrepancies between patients physicians	and insurances


Responsibilities and Duties:
• Lead and manage authorization team effectively and efficiently train employees
• Review authorization queue for applicable orders
• Verify and comply with payer contractual authorization requirements
• Submit authorization request timely and efficiently, ensuring proper documentation is included for review
• Utilize website portal, and electronic options to submit authorization requests
• Work with management to identify payer trends or potential issues
• Demonstrate exceptional customer service skills in the performance of work assignments and duties
• Scheduling and re-scheduling patients appointments with accordance with established protocols
• Run daily logs for doctors and administrators 2-3 times a day
• Verify patients eligibility through health plan and patients IPA
• Maintain confidentiality of medical information
• Alert staff, management and patients of any identified potential coverage issues

Lead Authorizations Coordinator

Responsibilities:
• Provided prompt, accurate, and courteous customer service to clientele, in all manner communication and strict quality control guidelines.
• Utilized various financial data management systems to provide in depth information to customers for retention. Processed various claims/transactions and identified opportunities to assist clientele where needed.
• Maintains complete records on all accounts including, but not limited to, detailed documentation on all efforts, proof of timely filing, authorization hardcopies, correspondence from insurance for eligibility and benefits.

Member Relations Representative

Achievements:
• Experience with sales/marketing, claim processing and order management functions at many levels of the order process for member, providers, and health care networks.
• Meeting and exceeding personal customer service and sales standards and those set by management, upholding standards of ethics and excellence above and beyond the standards of peers by providing a rewarding customer satisfaction experience.
• Achieved productivity goals by utilizing telephone based approaches.

Responsibilities and Duties:
• Researched and provided courteous, accurate and timely responses to inquiries by health plan providers and members as related to referrals, authorization, and eligibility inquiries.
• Billers are explaining balances, reviewing accounts for accurate billing, handle and resolve disputes from patients and provider, forward escalated issues as required to customer services supervisors.
• Verified members eligibility, insurance, benefits and coverage.
• Handled high volume for internal/external customer base.

Find out detailed information about Katherine Le,  in Garden Grove, CA

Katherine Le: in Garden Grove, CA

Katherine Le

Coastline Community College