Roxann Knox

Background

About Roxann Knox

Primary Duties- Medicare Processor A working knowledge of medical claims, determine if the claim needs an ORM date, ICD-9 or ICD 10 code is needed to close medical claim for insured- Review claims to add expiration date or benefit exhaust date according to state guidelines and policy. Review claims for missing information, date of birth, social security number and other information. Send necessary letter to Medicare to close the claim, review SSN letters and other letters and document claims accordingly.Provide excellent customer service to internal and external members. Explain benefits and coverage information to members, gave status of claims to insured and providers. Heavy data entry skills required to enter healthcare demands in the Mitchell system for the adjustor to review. Respond to letters from health insurance companies to determine what company would responsible for payment and request ERISA paperwork from insurance companies. Provide excellent customers service to insured and providers with status of claims and if additional information is needed document the claims appropriately.Attorney Mail Clerk review letters from attorney documented claim and provided attorney with information, example declaration page, status of medical claims, documenting letter of representative and sending all information in a timely matter.Claims Processor- Provided excellent customer service to insured and providers. Review and explained coverage, sent necessary forms, sent letters to Third Party Carrier for subrogation clause if needed. Called providers to get additional information to pay claims Review and paid medical claims up to policy limit and authority given.