I'll go first. I did lots of policy writing, and SOP writing with a medical insurance company. I was often forced to do phone customer service as an "additional duties as needed" work task.
On this particular day, I was doing phone support for medicaid customers, during the covid pandemic. I talked to one gentleman that had an approval to get injections in his joints for pain. (Anti-inflamatory, steroid type injections.) His authorization was approved right when covid started, and all doctor's offices shut the fuck down for non emergent care. When he was able to reschedule his injections, the authorization had expired. His doctor sent in a new authorization request.
This should have been a cut and dry approval. During the pandemic 50% of the staff was laid off because we were acquired by a larger health insurance conglomerate, and the number of authorization and claim denials soared. I'm 100% convinced that most of those denials were being made because the staff that was there were overburdened to the point of just blanket denying shit to make their KPIs. The denial reason was, "Not medically necessary," which means, not enough clinical information was provided to prove it was necessary. I saw the original authorization, and the clinical information that went with it, and I saw the new authorization, which had the same charts and history attached.
I spent 4 hours on the phone with this man putting an appeal together. I put together EVERY piece of clinical information from both authorizations, along with EVERY claim we paid related to this particular condition, along with every pharmacy claim we approved for pain medication related to this man's condition, to demonstrate that there was enough evidence to prove medical necessity.
I gift wrapped this shit for the appeals team to make the review process as easy as possible. They kicked the appeal back to me, denying it after 15 minutes. There is no way it was reviewed in 15 minutes. I printed out the appeal + all the clinical information and mailed it to that customer with my personal contact information. Then I typed up my resignation letter, left my ID badge, and bounced.
24 hours later, I helped that customer submit an appeal to our state agency that does external appeals, along with a complaint to the attorney general. The state ended up overturning the denial, and the insurance company was forced to pay for his pain treatments.
It took me 9 months to find another 9-5 job, but it was worth it.
I was working for a guy setting to 2.4Ghz WiFi links up to 10 miles from a tower. I was mainly running the office and doing network tech support with the odd pc repair job. He was working for a conglomerate about 5 hours away. He had an installer who would come through every couple weeks so I would have the equipment configured and ready to go for him, he would also grab stuff that was no longer in service and bring it back to the office.
Anyway the installer quit and I had to drive 2 hours each way to go get the truck. No big deal but now no installer. Had a friend who was smart enough to do the job and learn so started going with him and teaching him what to do and how to set stuff up. We did a couple jobs no problem, our longest connection being 7.5 miles on a mast about 20 feet tall. Get to a site to set things up and could literally see the tower but no connection, owner was no help but he had plotted it all out in software showing we software have a great signal. Ask he could say was just to get more height and get it done. Signal went from barely there to non existent. He had told the woman for months that it wouldn't be an issue and we would get her setup when her landlord agreed to the equipment install.
Figured out that the issue was that the sector antenna were installed with a 5 degree downward cant. We were slightly above the tower even though it was in line of site we would have needed to be lower down the hillside on another person's piece of property to get a stable signal then have a couple repeaters to make it work. So here I am with a pissed off woman who was told over and over it would work and I can't provide what was promised, give him a call and he stopped answering.
I apologized to the woman and told her someone would be back, gave her his cell number, and packed up the truck. Went to the office, locked up the truck, and dropped the keys in the office mall slot.