Anne Posadas

• AR- Follow Up
• Calling Medical Insurance regarding claims denial and payment
• Claims Submission, appeal process
• EPIC tool user

• Worked as Team Leader under Healthcare account
• Handled Claims , eligibility & benefits concern under Provider line
• Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
• Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.

Healthcare Account (Professional and Facility Claims)

• Receiving inbound calls from Provider's regarding claims, eligibility and Benefits , authorization status
• Claims Denials familiarity
• Promoted as Provider Escalation Team - Handling Complaints and complex claims (Claims Manual Adjusting , Claims processor)
• Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
• Transferred to Balance Billing Team - receiving calls from member's regarding claims billing from Provider, handling complaints and frustrations.
• Doing outbound calls to Provider regarding incorrect billing of the patient, doing end to end process.

• Healthcare account (Prescription Drug Plan)- Handled 2 Line of Business (Billing, Eligibility & Benefits)
• Receiving inbound calls from member/patient's regarding copays and premium concerns.
• HIPAA knowledge
• Medicare and Medicaid process knowledge
• Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
• Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.