Deonne Henry

Cob R Analyst @Blue Cross Blue Shield of Michigan

Detroit, MI, US

Verifies and reconciles provider/vendor identified claim overpayments. Updates records and prepares responses to providers-Researches and analyzes MA Plan payment data, CMS COB data, OHI records, and CMS ECRS system to determine the validity of MSP plan payment reductions and completes actions to restore premium reductions-Supports the recovery of aged account receivables due to medical claim overpayments-Investigates Part C/D COB data and eligibility leads to identify potential COB, verify other health information, and establish MSP coordination periods. Adds, updates and/or corrects OHI records in pharmacy and medical claims processing systems including submitting COB data to CMS-Prepares, tracks, and delivers validated claim adjustment requests to appropriate vendor-Receives and reconciles recovery responses related to overpayments including other carrier coverage and changes in member enrollment data-Loads and processes checks related to recovery of overpayments. Reconciles claim adjustments and cash received to recovery submissions-Researches and locates CMS and/or internal policies to ensure compliance.

Central Michigan University

Bachelor’s Degree

Central Michigan University

Master of Science in Administration