Care as a General Practitioner, focusing on prevention, accurate diagnosis, and effective treatment. I aim to continuously improve my skills and work collaboratively with healthcare teams to ensure the best outcomes for my patients and contribute to the overall health of the community.
• Justified medical cases to payers, specifically detailing emergency and life-threatening conditions, and determining eligibility for the program.
• Managed referral and transfer cases, ensuring emergency or life-threatening cases were processed under the program.
• Approved eligible cases for coverage under the program.
• Worked closely with the corporate team to maintain and support the ABM mandate program, ensuring that eligible patients were covered.
• Trained financial counselors on how to submit cases and justify medical emergencies to payers effectively.