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 any organization. Aiming to leverage the abilities to successfully fill the vacancy at a company. Frequently praised as hard-working by co-workers, can be relied upon to help company achieve its goals.
Overview
13
13
years of professional experience
Work History
Operations Supervisor, Case Management
Pear Therapeutics
Raleigh, North Carolina
08.2020 - 04.2023
- Evaluated team member performance and productivity, provided feedback and implemented corrective actions on brand new therapeutic area, Prescription Digital Therapeutics
- Contributed ideas/solutions for program enhancements that solved/improved workflows
- Maintained and exhibited expertise in leveraging CRM Salesforce to manage assigned responsibilities
- Managed personnel administrative duties, including recruiting, hiring, staff timekeeping, & performance reviews
- Maintained expertise in subject matter while following best practices.
- Collaborated with internal and external stakeholders to ensure compliant program administration
- Built and maintained relationships with field Sales team
- Managed 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
- Educated providers, staff, and patients' on Pear products during on-site visits
Oncology HUB/Reimbursement Supervisor
TrialCard
Morrisville, North Carolina
07.2019 - 08.2020
- Provided Support to Program Managers
- Developed and implemented hub operational plans to ensure client work flows.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs
- Monitored workflow to improve employee time management and increase productivity
- Evaluated employee performance and coached and trained to improve weak areas
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows
Reimbursement Specialist: Team Lead
TrialCard
Morrisville, North Carolina
11.2018 - 07.2019
- Managed phone and case queues
- Updated and trained the team on procedure changes, providing support to PMs
- Reviewed Verification of Benefits/PA/Appeals processes for the Reimbursement Specialist team
Reimbursement Specialist
Aerotek/TrialCard
Morrisville, North Carolina
10.2017 - 11.2018
- Processed cases in a production-driven environment, reviewing patient information to determine eligibility for services
- Conducted in-depth research on patient issues to provide quality resolutions.
Insurance Specialist
PFS Group
Morrisville, North Carolina
12.2016 - 09.2017
- Managed accounts in a production-driven environment, communicating with patients to establish present insurance coverage
- Coordinated with insurance companies to ensure timely resolution of account balances
- Determined patient eligibility for dates of service.
Reimbursement Specialist
Remex/Biologics-McKesson
Cary, North Carolina
10.2016 - 11.2016
- Processed cases in a production-driven environment, reviewing patient billing and medical information to determine eligibility for services
- Conducted in-depth research on patient issues to provide quality resolutions.
Office Manager
West Cary Wellness
Cary, North Carolina
10.2010 - 06.2016
- Successfully transitioned office workflows from paper to online
- Launched/Managed successful weightloss program
- Proficiently managed the cash flow for the office/owner
- Managed online insurance filing, verifications, disputes, reconciliations
Education
2 Yr Certification; Data Entry/Emphasis On Computer Applications - Data Entry
Suburban Technology
East Islip, NY06.1990
Skills
- KPI reporting and medical record management
- Medical Terminology, HIPAA Policies, and Software Systems
- Reimbursement and Case Management expertise
- Insurance Regulations, Medical claims and insurance verification with commercial/government payers
- Collaborative Problem Solving
- Site visits and Education
- Employee Motivation and Training
- Program Operations and Solutions Implementation
- Organizational Culture and Innovation
- Assessed travel assignments
- Fluent in Spanish
Languages
Spanish
Native/ Bilingual
Timeline
Operations Supervisor, Case Management
Pear Therapeutics
08.2020 - 04.2023
Oncology HUB/Reimbursement Supervisor
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/Biologics-McKesson
10.2016 - 11.2016
Office Manager
West Cary Wellness
10.2010 - 06.2016
2 Yr Certification; Data Entry/Emphasis On Computer Applications - Data Entry
Suburban Technology
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