Gary Rowlet

Maintains critical provider information on all claims and provider databases. Validates data to ensure adherence to business and system requirements for contracting, network management, and credentialing.

Reviewed and validated pre-payment or post-payment claims for potential savings. Utilized various techniques including systems-based queries, specialized reporting, and other research to recover claim over-payments.

Gathered clinical information for cases and determined appropriate referral or assignment. Interfaced with providers and facilities to provide case-related information.

Processed incoming requests and collected information for review from providers. Screened basic and complex requests for precertification and prior authorization using scripts.

Assisted with various tasks in designing and creating websites for customers. Collaborated to meet customer needs and expectations for a superior product.

Received calls from customers and explained the process and guidelines for applying for TSA Pre-check. Tracked and analyzed customer statuses using Excel Spreadsheets.

Received inbound calls from customers and answered questions about Medicare supplemental policies. Responded to inquiries from medical providers and agents, and assisted the claims department.

Received inbound calls from COBRA Health participants and answered questions concerning their health insurance policies. Assisted various companies with updates of participant coverage.

Assisted WFHM customers with questions regarding their mortgages. Successfully cross-sold mortgage products to benefit the homeowner.

Earned a Financial Services Academy Certificate, gaining expertise in financial principles and services. Also obtained an Accredited Customer Service Representative Certificate, enhancing skills in customer support and relations.

Completed high school education and received a diploma.