Dvonya Young

Inbound Phone Queue

Pharmacy triage and coordination

Order processing for wholesale orders

Other follow up activities

Researches and resolves any claim denials and underpayments of claims

Reports any trends or delay to program management

Ensures all programs correspondence and communication meets quality standards

• Verified insurance eligibility and coverage for patients.
• Processed medical records requests efficiently, safeguarding patient privacy while ensuring timely information access for healthcare providers.

Billing and coding support

Claims assistance tracking and submission

Prior Authorization assistance

Benefits verification results call

Welcome calls

Ensures all programs correspondence and communication meets quality standards

Determination for support programs

Provides exceptional customer service to internal and external customers

Resolves any customer request in a timely manner; escalate complaint accordingly

• Maintained up-to-date knowledge on industry regulations, ensuring compliance throughout all benefit verification processes.
• Performs claims integrity by researching and identifying insurance information for members
• Verifying patients and claimants information, the payer network, in-or out of network status
• Research any/all information to determine coverage levels to include calling insurance providers or accounts when necessary
• Calculate deductible, out-of pockets cost and copays
• Provides updates on any /all benefits investigations related to the membership financial responsibility