Danyale Miles
Hewitt
Summary
Dedicated healthcare customer service professional with over 10 years of experience in high-volume environments. As an Inbound Contact Representative II, expertise includes benefits, claims resolution, and enrollment support. Knowledgeable in Medicare/Medicaid and HIPAA compliance, with a strong record of resolving complex issues and enhancing customer satisfaction.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Inbound Contact Representative 2
Humana
10.2024 - Current
- Received inbound calls from healthcare providers to address inquiries.
- Resolved complex inquiries related to benefits and claims for clients.
- Documented inquiries, comments, and complaints, ensuring appropriate follow-up actions were taken
- Escalated unresolved provider issues to ensure timely resolution and improved communication
- Resolved incomplete applications by identifying and obtaining missing information
- Research members' information to complete their enrollment
- Send letters to members or emails to agent when applications cannot be submitted
Patient Access Representative
Conifer Health Solutions
Bryan
11.2021 - 11.2024
- Schedules mammograms, diagnostics, biopsies, MRIs, ultrasounds and bone densities.
- Scheduled appointments for patients and medical professionals regarding breast health.
- Verifying patients' demographics and insurance.
- Processed insurance estimates and communicated financial responsibilities to patients.
- Applied knowledge of ICD-10 and CPT codes to ensure correct coding practices.
- Gained understanding of Medicare and Medicaid guidelines to verify patient eligibility.
- Managed documentation and orders for mammogram and ultrasound technicians.
- Scanning patients' documentation & orders in their accounts.
Customer Service Associate
Alltran
Bryan
05.2019 - 08.2021
- Managed customer accounts as customer service associate at Toyota/Lexus Financial Services, ensuring timely resolution of inquiries and enhancing customer satisfaction.
- Assisted customers with inquiries and resolved issues effectively.
- Managed customer accounts and updated information accurately.
- Provided product information and guidance to enhance customer experience.
Customer Service Representative
Adecco Staffing
College Station
05.2016 - 03.2019
- Executed debt collection efforts and ensured account accuracy while addressing customer concerns through inbound calls, resolving issues efficiently.
- Reviewed employee proxy calls to uphold service standards, ensuring consistent quality in customer interactions.
- Managed investor communications and facilitated proxy voting process through outbound and inbound calls, enhancing stakeholder engagement.
Education
Diploma -
Hearne High School
Hearne, TX05-2006
Skills
- Insurance verification
- Claims support
- Insurance prior authorization
- Customer service
- Client assistance
- Client relations
- Client support
- Microsoft Word
- Call Center
- Appointment scheduling
- Order processing
- Billing inquiries
- Regulatory compliance
- EClinicalWorks
- CRM software
- Microsoft Office
- Microsoft Excel
- Client assistance
- Microsoft Powerpoint
- Microsoft Outlook
- SharePoint
- Time management
- Organizational management
- Analysis skills
- Escrow
- Banking
- Financial Services
- Mortgage Servicing
- Senior Care
- Hospital experience
- ICD-9
- Lead generation
- Service communication
- Customer engagement
- Verbal communication
- Phone etiquette
- Care plans
- CSR
- Computer literacy
- Care plans
- Analysis skills
- Microsoft Excel
- Organizational management
- Claim resolution
Certification
Driver's License
Hybrid Work
True
Additional Information - Authorized To Work
US
Personal Information
Authorized To Work: US
Timeline
Inbound Contact Representative 2
Humana
10.2024 - Current
Patient Access Representative
Conifer Health Solutions
11.2021 - 11.2024
Customer Service Associate
Alltran
05.2019 - 08.2021
Customer Service Representative
Adecco Staffing
05.2016 - 03.2019
Diploma -
Hearne High School