MIchael Haynes

Key Responsibilities:

• Claim Assessment: Evaluate submitted claims for accuracy, ensuring all required medical reports, invoices, and member details are included.
• Investigation: Liaise with healthcare providers and members to gather information in order to finalise claims.
• Decision Making: Approve or deny claims based on policy guidelines and evidence.
• Customer Service: Communicate claim decisions, assist members with inquiries, and handle escalations.
• Compliance: Ensure adherence to CBHS policies and regulatory requirements, while maintaining accurate records.

Key Responsibilities:

• Member Interaction: Respond to phone, email, and online inquiries regarding a member's health insurance policy.
• Policy Explanation: Clearly communicate plan details, coverage options, and benefits.
• Claims Processing: Assist with claim submissions, verify eligibility, and track claim status.
• Policy Changes: Process updates such as personal details, dependents, and coverage modifications.
• Problem Resolution: Investigate and resolve member concerns or complaints.
• Cross-Selling: Identify opportunities to offer additional insurance products.

Key Responsibilities:

• Guest Engagement: Greet guests, confirm reservations, and understand their wellness needs.
• Booking & Lead Management: Use the CBHS iPad to capture leads, schedule sessions, and direct inquiries appropriately.
• Sales & Payments: Assist with retail product sales, and process payments.
• Knowledge & Communication: Maintain a strong understanding of CBHS wellness center offerings, and articulate the benefits of the wellness program.