Managed Care Representative
Florida Center for Allergy and Asthma Care
Dec 2022 - Current (3 years 8 months)
As a Managed Care Representative, I am responsible for responding to inquiries regarding healthcare plans, providers, and health plan operations, ensuring clients receive accurate information about benefits, claim resolution, referrals, and general clinic details. I process and follow up on requests for referrals to specialists or other services, verifying the necessity for pre-certification or authorization. Additionally, I assist with scheduling appointments and help patients obtain medical supplies, find primary care providers (PCPs) and specialists, and access community resources. My role includes eligibility and benefit verification, confirming patients' insurance coverage and benefit details, as well as documentation handling to ensur
