United Behavioral HealthSite Services Representative (Technical Expert)
Jan. 2006 - Dec. 2006Greater Minneapolis-St. Paul AreaDuties included investigating Attorney General & Regulatory complaints, formatting all levels of complaint resolution recommendations and liaising with various departments to ensure recommended action taken, following cases to completion. Investigate complaints involving system errors; involve necessary departments to ensure resolution, whether in changing procedures or enhancing the system. Performing all levels of claims research & issue resolution, investigating and writing benefit and claim exception proposals for presentation to senior management, petitions in timely filing cases, provides consultation & back-up for team leads. Provides education to providers on correct billing & resolves disputes about contract rates and procedures. Managing daily central email box for complex issues which require investigation, responds to all parties within a timely manner, and communicates issues and procedure changes to managers & team members in daily updates as well as in meetings. Back up the Customer Service Dept when call volumes are very high, answer questions and take over escalated calls from the customer service coordinators. Listen in to calls and provide feedback to customer service agents for improved service.