A large health plan had a severe backlog in reviewing records and determining pay denial of claims. Jacobson provided a team of work-at-home medical review nurses who worked through the backlog in less time than expected, completing the project two months early.
This Blue Cross Blue Shield plan was not meeting CMS requirements and turned to Jacobson for a consultant who could improve policies and procedures and train the existing staff.
After a poor CMS audit, this health plan was in need of a consultant who could correct the problems and respond to CMS for a validation audit. Jacobson’s consultant utilized a background in Medicare compliance and CMS audit experience to quickly put together a corrective action plan.
A health plan was struggling to pass the Center for Medicare and Medicaid Services’ audits. Jacobson’s expert was able to handle Medicare Part C and Part D grievances, complaints and appeals.
This nonprofit health plan was in the process of developing its underwriting department. At the time, its clerical staff and nurses were handling underwriting activities and had grown its inventory to 11,000 applications. Our consultants were able to quickly eliminate the backlog, setting the bar for the client as they recruited permanent staff.
A Southwestern health plan was experiencing difficulty handling their call volume, resulting in long hold times and high abandon rates. Jacobson quickly provided a team of customer service representatives to address the client’s call volume.
This mission-critical project was driven by this plan’s own clients. Dental CSRs were needed to verify coverage information and document provider data. We customized a virtual solution, and our staff was at full production the first day on assignment.
When our client moved from a Claimfacts system to Trizetto’s Facets system, the high-complexity and high-volume plans caused a significant delay. With several thousand unique products to configure, Jacobson quickly provided an experienced consultant able to produce immediate results.
This organization needed assistance improving its asset liability management (ALM). Jacobson quickly provided an actuary with significant ALM, market risk and governance expertise to help the company create a better framework.
When a single-state homeowners insurer began to see rapid expansion of their products, they realized their team of actuaries was struggling to keep up with demand. Jacobson placed an expert with decades of ratemaking, pricing and filing experience to help this insurer get up to speed in less than 10 weeks.
A Midwestern health plan was in need of an expert who could help them better understand and overhaul overhead costs by business line. Jacobson quickly supplied an experienced consultant who delivered exceptional results.
This company acquired an asbestos book of business that was in run-off and found it challenging to find a permanent actuary with asbestos reserving experience. Jacobson supplied a senior-level actuary with asbestos reserving expertise on an as-needed basis for several years.