MedWatch, LLC

• Manages an individual caseload using the Case Management process • Authorization of services • Review of treatment plans for medical necessity • Ongoing communication with all members of the health care team • Review all medical data which can be provided to establish, update and maintain accountability for a Case Management plan • Assess problems and determine goals and actions designed to meet the needs of the patient and document this into case notes • Determine if these goals are long term or short term and how the patient can be expected to meet those goals • Adhere to all company policies as stated in the employee handbook • Participate in the Quality Management Program by adhering to all company policies and procedures and identifying opportunities for improvement

• Manage an individual caseload using the Case Management process to meet the needs of MedWatch, LLC customers and consumers • Authorization of services • Review of treatment plans for medical necessity • Ongoing communication with all members of the health care team • Review all medical data to establish, update, and maintain accountability for a Case Management plan • Incorporate contact with providers, payers, the patient and the patient's primary caregiver • Assess problems and determine goals and actions for patient needs and document in case notes • Determine if goals are long term or short term and how the patient can meet those goals • Make contact with payer office to understand benefit constraints impacting the plan of action • Adhere to all company policies and participate in the Quality Management Program

• Analyzing, designing, implementing, and supporting business applications and systems • Elicit, analyze, communicate, and validate business/user requirements for processes, policies, and systems • Translate business needs/end-user requirements into functional specifications that describe what the system, process or product/service must do • Demonstrate ability to learn to configure supported systems to meet defined functional requirements • Assist in the execution of detailed system level application support and issue resolution • Formulates and defines system scope and objectives through research and fact-finding combined with an understanding of applicable systems and industry requirements • Recommends system usage improvements to enhance departmental workflow and efficiency • Serve as a liaison between business groups and IT Development to clarify requirements, review recommendations and answer questions • Identify/documents how applications and systems interact to support business processes • Verify through testing that changes made by programmers to one part of the application do not impact other parts • Create training documents and facilitate user training on new systems and/or process implementations

• Perform a variety of routine duties to assist in the collection of payment on delinquent accounts • High volume of outbound calls / emails to collect past due balances and determine reasons for non-payment • Continually monitor customer’s account status by utilizing reporting resources and spreadsheets • Issue monthly statements of amount owed, payments, adjustments and any interest charges applied • Perform account and payment reconciliations • Research account disputes and billing discrepancies • Prepare adjustments/write-offs for approval by the Director of Accounting • Respond to customer inquiries and assist with questions related to the status of their account(s) • Document daily collections activity to include date, times of contact and any change in customer account status.

• Respond to telephone and email inquiries received from members and provider within defined service standards. • Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers. • Assist members with benefits and healthcare questions. • Document all calls received in system-based call log. • Handle all incoming MedWatch precertification calls (i.e., start cases, do call logs, forward calls, provide case status, provide claims phone #’s, etc.) • Make outgoing calls for MedWatch (demos, information for case completion, re-direction for network steerage, etc.) • Complete incoming electronic Web-certs. • Verify patient and provider demos – correct and/or complete when needed.

• Conduct the Utilization Review process by obtaining medical information and confirming the medical necessity of hospital admissions and/or outpatient procedures • Identify her/himself by first name, title, and organization name when a call is made to or received from a facility, provider, or patient • Perform preadmission review for medical necessity of hospitalization and surgery • Assign diary date for review of continued hospital stay • Perform review for necessity of Second Surgical Opinions • Precert physical therapy for medical necessity • Perform review of medical necessity for designated outpatient tests and durable medical equipment • Perform initial and concurrent reviews during hospital stays • Notify claims office and re-insurer • Conduct phone inquiries to hospital/physician personnel regarding patient continued stay treatment and discharge status

• Identifying and qualifying potential business opportunities • Acts as the initial point of contact for prospective clients • Engaging with them to listen and understand their needs • Introducing them to appropriate MedWatch products or services • Develop and maintain strong relationships with prospects, key clients and understand their goals, challenges, and opportunities • Meet key performance metrics (KPIs) for client success, ensuring achievement of targets related to client satisfaction, retention, and expansion • Evaluate leads generated from marketing campaigns to determine their potential as sales opportunities • Reach out to potential customers through current relationships with consultants, brokers and industry contacts as well as cold calling and emails • Build relationships and cultivate strong, long-term relationships with clients • Must have a consultative approach to their sales • Serve as a client advocate, representing their interests and ensuring they derive maximum value from our solutions • Keep up-to-date with new products, services, and pricing/payment plans • Continue to manage / support and work with sold clients in coordination with MedWatch’s Account Managers

• Assist Sales Executives with preparation of proposals, RFP/RFI responses, and sales presentations • Compile and organize required documentation for prospective clients (case studies, service descriptions, pricing inputs, etc.) • Maintain version control and accuracy of sales materials • Enter and maintain prospect and opportunity data in CRM systems • Track sales activity, follow-ups, and next steps • Assist with reporting on pipeline activity, proposal volume, and response timelines • Coordinate internal requests related to sales efforts • Schedule sales meetings, demos, and follow-up calls • Assist with conference registration and coordination • Serve as a point of contact for internal sales-related questions and documentation needs • Maintain and organize shared sales folders, templates, and standard documents • Assist with updating sales collateral and ensuring materials reflect current offerings • Provide administrative and operational support to the Sales and Marketing teams as needed • Participate in sales and cross-functional meetings when appropriate • Perform other duties as assigned to support sales effectiveness

• Maximize client satisfaction and retention while driving growth and profitability. • Ensuring that clients remain satisfied and continue to do business with the company. • Proactively addressing issues, providing high-quality support, and delivering value. • Maintain a thorough working knowledge of the MedWatch CMS system. • Manage assigned block of TPA’s/groups with multiple services, benefit plans and vendors. • Identifying opportunities for upselling or cross-selling additional services or products to existing clients. • Work with MedWatch internal departments to help investigate and resolve client issues. • Designing and implementing processes to onboard new Clients/Clients and their groups. • Coordinate and Facilitate Quarterly/Semi-Annual Client Meetings. • Use client feedback and performance metrics to continuously improve the client experience. • Present Fee Schedule Renewals and New Products to Clients.

• Manage an individual caseload using the case management process • Authorization of services • Review of treatment plans for medical necessity • Ongoing communication with all members of the health care team • Assess problems and determine goals and actions designed to meet the needs of the patient • Document into the case notes • Make contact with the payer office • Proceed with contacting medical care providers and with equipment vendors • Make care arrangements for quality patient care • Collaborate with the Case Management Assistant • Maintain responsibility for the Case Management file • Prepare timely reports to the payer