Jefferson

Healthcare Account Specialist

70 ID PROOF
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Overview

Looking for full-time work (8 hours/day)

at $5.00/hour ($880.00/month)

Bachelors degree

Last Active

March 14th, 2025 (yesterday)

Member Since

February 3rd, 2025

Profile Description

As a Healthcare Insurance Specialist I help individuals, families, and businesses understand and navigate health insurance plans. My role can involve a variety of tasks, including:
Advising clients on choosing the right health insurance plan based on their needs, budget, and eligibility.
Explaining insurance options (e.g., PPO, HMO, HDHP) and helping clients understand the benefits and costs of each.
Assisting with claims and coverage – Helping clients with the claims process or appeal denials, ensuring the client gets the coverage they are entitled to.
Staying up-to-date with regulations – Healthcare insurance is complex and constantly evolving. Specialists stay informed about changes in the law, including those related to the Affordable Care Act (ACA), Medicaid, Medicare, and other healthcare programs.
Educating on benefits – Specialists help clients understand their plan’s details, like premiums, deductibles, copays, and out-of-pocket costs, to ensure they’re making the most of their insurance.

Top Skills

Experience: 2 - 5 years

Outbound calling, taking inbound calls, email communication, cold calling, coordination and scheduling according to campaign directives. In order to provide a fair and honest transaction, intermediary negotiating processes, and client consultation on market circumstances, prices, mortgages, legal requirements, and related matters. Obtains client/customer information; interviewing clients; and verifying information. Following up customer/client calls as required. Evaluating acquired information from customer/clients for submission and/or processing. Meets individual/team qualitative and quantitative targets.

Experience: 2 - 5 years

Working with Centene Corporation, a US healthcare insurance company, specifically working with Ambetter-Marketplace Healthcare Insurance. Take Provider calls and provide accurate, satisfactory answers to their queries and concerns. Reviewing member/patient’s benefits and eligibility information according to the needs of the provider for verification. Reviewing, providing option on making an appeal about medical claims that are denied. Reviewing the status of medical authorizations as well as checking status of appeal related to it. Checking credentialing status of the provider and providing options on how to join Ambetter’s network. Assisting provider with their web portal activation, verification, and trouble shooting some issues.

Other Skills

Basic Information

Age
27
Gender
Male
Website
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Address
Botolan, Zambales
Tests Taken
IQ
Score:  99
DISC
Dominance: 33
Influence: 30
Steadiness: 32
Compliance: 6
English
C2(Advanced/Mastery)
Government ID
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