Elyse M Ingram

Remote Utilization management I agent - 3 month contract

Anthem Blue Shield - Woodland Hills, CA June 2021 to September 2021

• Responsible for coordinating cases for precertification and prior authorization review

• Manage incoming pre and post service claims work

• Responsible for the identification and data entry of referral requests into the UM system

• Provide authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.

• Determine contract and benefit eligibility

• Conduct clinical screening process

• Refers cases requiring clinical review to a Nurse reviewer

Remote Call Center Agent – Contract Full-time

FortunaBMC - McClellan Park, CA December 2020 to June 2021

· Determines requirements by working with customers.

· Answers inquiries by clarifying desired information by researching, locating, and providing information · Resolves problems by clarifying issues, researching and exploring answers and alternative solutions, implementing solutions, and escalating unresolved problems

· Fulfills requests by clarifying desired information; completing transactions, and forwarding requests.

· Maintains call center database by entering information.

· Keeps equipment operational by following established procedures, and reporting malfunctions.

· Enhances organization reputation by accepting ownership for accomplishing new and different requests, and exploring opportunities to add value to job accomplishments

Medical Receptionist – Full-time

Foot and Ankle Alliance - San Fernando, CA June 2014 to December 2017

· Successful operation and management of busy multi-line phone system

· Facilitate patient check-in and registration for surgical center and office locations

· Maintain front office flow by notifying doctor of patient arrivals and acting as liaison between patients and staff

· Schedule patient appointments and coordinate calendars for both surgical center and office locations · Verify patient benefits, collect copayments, and update patient information within EHR system as needed

· Assist clients with any questions or concerns

· Perform various computer-related tasks using MS Office and eClinicalWorks software