Elhim Elhag

Supervisor Provider Inquiry Call Center @Health Alliance Plan

Canton, MI, US
MOBILE NUMBERS
+91 *********19

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WORK HISTORY

Aug 2020 — Present

Supervisor Provider Inquiry Call Center @Health Alliance Plan

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MI, US

Supervise and coordinate all workflow activities within the Provider Inquiry Department such as phone monitoring, queue and case assignments schedules. • Handle escalated calls and emails related to claims related issues and/or discrepancies.• Determine training, policies, procedures, and benefit needs related to Provider Inquiries.• Maintain quality control based on Provider feedback via letters, phone, e-mail. HAP\'s website, and quality audits.• Evaluate employee performance, initiate appropriate coaching and developing and implement disciplinary action within area of responsibility.• Develop the Call Center Statistical Analysis Reports on a daily/monthly/annual basis, including developing all associated written policies and procedures.• Focus on continuous improvement and the development of staff in a customer-oriented way.• Interface with the Customer Services Correspondence and Grievance sections to be involved in an integral part of resolution for member complaints/grievances received by HAP.• Develop processes/measures that will ensure staff receive continuing education on most current benefits, products, policies, procedures, and systems tools.• Assist and/or handle Provider complaints.

EDUCATION

N/A

Touro University

Bachelor of Science (BS), Human Services, General

N/A

Borough of Manhattan Community College

Medical billing and coding

SKILLS

Customer ServiceTrainingManagementHealth InsuranceManaged CareHmoProvider RelationsUtilization ManagementMedicaidAdult EducationU.s. Health Insurance Portability and Accountability Act (Hipaa)Healthcare IndustryMedicare AdvantageHealthcareCall CentersCredentialingMedical ManagementMedicareHealth PolicyClaimClaims HandlingHipaaInsuranceMedical BillingFida

ABOUT ELHIM ELHAG

Eighteen years of experience in Managed Care, with a Background in Member Services, Provider Services, Utilization management, Behavioral Health and Claims. Knowledgable in Medicare,Medicaid, MLTC, PPO, HMO, FIDA and the Exchange.

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Elhim Elhag — Supervisor Provider Inquiry Call Center at Health Alliance Plan in Canton, MI, US | Unifers