MAC Customer Service
This Medicare Administrative Contractor (MAC) was deflecting 90 percent of received calls and only answering an average of 4,000 calls for every 55,000 inbound calls.
Provider Network Manager
This client was responding to a proposal request for a new government-sponsored managed care plan. Challenged with meeting the required member and provider accessibility standards, Jacobson provided a professional with a background in managed care and provider network development, resulting in a successful completion of the project.
Customer Service
This Blue Cross Blue Shield client was experiencing a high volume of inbound calls from both members and providers. In order to preserve the client’s reputation for excellent customer service, Jacobson responded within four days with a team of 19 customer service representatives and a seasoned project manager.
Financial Recovery
A major Blue Cross Blue Shield plan’s inventory for unallocated cash was at an extremely unsatisfactory level. Jacobson sent a team of contractors to help with the backlog; within a year, the inventory had dropped significantly.
Benefits Configuration
A large managed care organization turned to Jacobson for support during a major reorganization and consolidation effort. Jacobson helped them develop a work plan, design an efficient process for configuring plans, and assemble and train a team of plan-building consultants to manually configure and test the system.
Claims Backlog and Recovery
A Blue Cross Blue Shield plan contacted Jacobson with a critical backlog of overpayment claims. Jacobson quickly arranged a team of claims professionals. Our team quickly addressed the backlog, correcting a huge amount of claims.
Enrollment Reconciliation
This leading health plan was experiencing enrollment discrepancies between its in-house database and CMS system. Jacobson quickly delivered a dedicated team that tackled the discrepancies, decreasing them from 22 percent to less than 3 percent.
Healthcare Reform Facets Trainer
As healthcare reform deadlines were approaching, a health plan desperately needed additional trainers. Jacobson worked quickly to identify a trainer with extensive healthcare reform knowledge and Facets technology expertise.
MAC Claims Backlog
In response to a significant backlog in written correspondence, this Medicare administrative contractor contacted Jacobson. After one week of condensed training, Jacobson’s staff of experienced customer service representatives handled more than 21,000 calls over the course of four months.
Systems Conversion
The staff of a third-party administrator was experiencing a steep learning curve and struggling to maintain productivity as they converted from a legacy system to Trizetto’s Facets. Jacobson provided a team that cleaned up the resulting backlog, cleaned up data files and trained client staff on the new system.
Provider Maintenance
Our client’s provider database contained many duplicate and outdated records, which had caused a significant claims inventory to build up. Jacobson provided a team who successfully cleaned up the database and tackled the pending backlog.
Provider Customer Service
This client completed a system conversion from their legacy system to Facets. Due to configuration issues and an extended ramp-up period, there was a substantial backlog of more than 50,000 claims. Jacobson’s team was able to quickly ramp up the project and positively impact call volume.