> Worked as an offshore agent for Cigna Healthcare insurance (Dental Department)
> Verified if the insured patient's plan is currently active
> Checked whether said plan has any Pre-authorization/s
> Investigated why a claim was denied or would be denied (under what grounds)
> Confirmed that a dental procedure to be performed would be covered under the insurance plan
> Helped provide the patient's dental benefits breakdown (Diagnostic, Preventive, Restorative, Endodontic, Periodontal, and Prosthodontics services).
> Helped out with Dental Appeals - If upon investigation the Provider's Claim got incorrectly denied, we would send back the claim to the respective department for reconsideration or advise the Provider to re-submit said claim (depending on the circumstances).
> Answered co-pay inquiries
> Checked if necessary attachments to the claim are completely sent (periapical,occlusal,bitewing or panoramic x-ray). If not, advise the Provider to re-submit to prevent claims denial.
> Assisted with other inquiries