Cayenne Wiley
Las Vegas,NV
Summary
A versatile professional with experience in operations, claims, and customer service. Excels at assisting companies in effectively managing projects. Keen eye for detail and commitment to efficiency ensures timely project completion. Background in operations, claims, and customer service equips with skills to streamline processes and optimize productivity. Contributes to the success of organizations by delivering results-driven project management solutions.
Overview
13
13
years of professional experience
Work History
Delivery Courier
Uber
Las Vegas, NV
07.2023 - Current
- Followed company policies and procedures during shift.
- Expedited urgent deliveries, prioritizing time-sensitive shipments to meet critical deadlines.
- Reduced customer complaints by providing timely updates and maintaining clear communication throughout the delivery process.
- Demonstrated a strong commitment to customer service excellence by maintaining a courteous demeanor in challenging situations and going above and beyond to ensure complete satisfaction.
Claims Analyst
Clover Health
08.2019 - 07.2023
- Processed medical insurance claims, using Amazon Workplace and Salesforce, to track and address patient needs
- Coordinate with Senior Analysts to process high value patient claims, mitigating risk and ensuring positive experiences
- Manage invoice processes, including high priority audits, to ensure timely delivery of payments and collection of data
- Followed regulatory compliance guidelines and policies to ensure proper HIPAA and medical protections are in place
HEDIS Team Lead / Clinical Operations Coordinator
Clover Health
08.2019 - 07.2023
- Monitored data queries, tracking risk adjustments and HEDIS, to measure patient care and outcomes
- Coordinated with providers and medical facilities to collect patient records and ensure accuracy of information
- Collected, reviewed, and cleaned data for use in vendor and governmental documentation and contracts
Operations Coordinator II
Aspire Healthcare
Nashville, TN
04.2016 - 11.2018
- Processed 80+ incoming calls daily, coordinating appointments, medical records, medicinal refills, and other client needs
- Update patient records, including demographics, insurance and account information, ensuring documentation accuracy
- Supported medical teams by recording notes, completing paperwork, and submitting forms to vendors and stakeholders
- Updated patient charts with lab results, consultation updates, and other health-related information
Call Center Triage
Comprehensive Pain Specialists
Nashville, TN
02.2014 - 02.2016
- Handled 100+ incoming calls daily from patients, vendors, and other medical offices
- Scanned, faxed, and filed documentation, ensuring office procedures were being followed and information was accurate
Customer Service
Nashville International Airport
Nashville, TN
06.2012 - 02.2014
- Managed customer relations issues and addressed client questions in a timely manner
- Processed work orders, transactions, and other office-related documentation, maintaining high levels of accuracy
Education
Medical Assistant Certification -
Nashville College of Medical Careers
Certified Nurse Assistant -
NATS
Marriage Officiant License -
State of Nevada
Notary Public Commission -
State of Nevada
Skills
- Data Monitoring
- Claims Processing
- Auditing / Billing
- Leadership
- Regulatory Compliance
- Records Collection
- Documentation
- Vendor Management
- Customer Service
- Remote work experience
- Microsoft Office Suite
- Customer Support (Phone/Email)
- Analytical Problem Solving
- HIPAA Privacy Laws
- Eclinicalworks
- Patient Call Center Triage
- Medical Confidentiality
- Salesforce
- Data Entry
- SQL
Remote Work
True
Timeline
Delivery Courier
Uber
07.2023 - Current
Claims Analyst
Clover Health
08.2019 - 07.2023
HEDIS Team Lead / Clinical Operations Coordinator
Clover Health
08.2019 - 07.2023
Operations Coordinator II
Aspire Healthcare
04.2016 - 11.2018
Call Center Triage
Comprehensive Pain Specialists
02.2014 - 02.2016
Customer Service
Nashville International Airport
06.2012 - 02.2014
Medical Assistant Certification -
Nashville College of Medical Careers
Certified Nurse Assistant -
NATS
Marriage Officiant License -
State of Nevada
Notary Public Commission -
State of Nevada