Summary
Overview
Work History
Education
Skills
Timeline
Generic

Dayana A. Hering

Creedmoor,NC

Summary

Ambitious Leader with strong organizational and multitasking skills, as well as an aptitude for technology. Ready to apply knowledge and skills to any challenge. Highly accomplished and results-driven Leader with 14+ years of expertise in access and reimbursement, adeptly navigating client-based programs. Ready to make an immediate contribution to your organization. Aiming to leverage my abilities to successfully ll the vacancy at your company. Frequently praised as hard-working by my co- workers, I can be relied upon to help your company achieve its goals.

Overview

13
13
years of professional experience

Work History

OUD CASE MANAGEMENT SUPERVISOR

Pear Therapeutics
08.2020 - 04.2023
  • Supervised, coached, and directed a team of Case Mangers for brand new therapeutic area, Prescription Digital
  • Therapeutics
  • Maintained and exhibited expertise in leveraging CRM Salesforce to manage assigned responsibilities
  • Managed personnel administrative duties, including recruiting, hiring, sta f timekeeping, and performance reviews
  • Maintained subject matter expertise in patient services and payer policies for Pear products, along with contact-center best practices
  • Collaborated with internal and external stakeholders to ensure compliant program administration
  • Built and maintained relationships with the eld Sales team
  • Manged escalations and provided resolutions
  • Contributed in User Acceptance Testing and implementing new service and program enhancements
  • Monitored operational metrics to achieve quality, productivity, and program standards
  • Led team in numerous virtual and on-site client launches

SUPERVISOR

ONCOLOGY HUB, TrialCard
07.2019 - 08.2020
  • Provide Support to Program Managers
  • Identi ed potential problems associated with the delivery of materials and services within the hub area.
  • Trained and supervised a team of 12+ employees on daily tasks/various roles related to the hub operations.
  • Developed and implemented hub operational plans to ensure e cient work ow.

REIMBURSEMENT SPECIALIST: TEAM LEAD

TrialCard
11.2018 - 07.2019
  • Managed phone and case queues
  • Updated and trained the team on procedure changes, providing support to PMs
  • Reviewed Veri cation of Bene ts/PA/Appeals processes for the Reimbursement Specialist team

REIMBURSEMENT SPECIALIST

Aerotek/TrialCard
10.2017 - 11.2018
  • Working cases from a queue in a production driven environment
  • Gathering, reviewing patient, medical information, demographics codes, and provider's information in order to determine if patient's qualifies for services
  • Conducted in depth research on patient issues in order to provide a quality resolution

INSURANCE SPECIALIST

PFS Group
12.2016 - 09.2017
  • Managed accounts in a production-driven environment, communicating with patients to establish presentinsurance coverage
  • Coordinated with insurance companies to ensure timely resolution of account balances/Determined patienteligibility for dates of service.

REIMBURSEMENT SPECIALIST

Remex/Biologic's-McKesson
10.2016 - 11.2016
  • Processed cases in a production-driven environment, reviewing patient billing and medical information todetermine eligibility for services
  • Conducted in-depth research on patient issues to provide quality resolutions.

OFFICE MANAGER

West Cary Wellness
10.2010 - 06.2016
  • Manager of busy Chiropractic office handling incoming patients, insurance billing, insurance verification, proficient in Microsoft Office software, Fortis software.
  • Account management/ Cash flow management for office and Dr.
  • Insurance Verification, billing, and Care Credit certified

Education

Suburban Technology
East Islip, NY
06.1990

Skills

  • Conflict Resolution
  • KPI reporting and medical record management
  • Medical terminology, HIPAA policies, Medical claims and insurance verification with commerical/government payers
  • Reimbursement and case management expertise
  • Multitasking and Organization

Timeline

OUD CASE MANAGEMENT SUPERVISOR

Pear Therapeutics
08.2020 - 04.2023

SUPERVISOR

ONCOLOGY HUB, TrialCard
07.2019 - 08.2020

REIMBURSEMENT SPECIALIST: TEAM LEAD

TrialCard
11.2018 - 07.2019

REIMBURSEMENT SPECIALIST

Aerotek/TrialCard
10.2017 - 11.2018

INSURANCE SPECIALIST

PFS Group
12.2016 - 09.2017

REIMBURSEMENT SPECIALIST

Remex/Biologic's-McKesson
10.2016 - 11.2016

OFFICE MANAGER

West Cary Wellness
10.2010 - 06.2016

Suburban Technology

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Dayana A. Hering