Dixili Cayon
Denton,TX
Summary
Results-driven professional with over 7 years in medical claims evaluation and management. Known for strong problem-solving abilities and effective communication, contributing to team efficiency and client satisfaction. Detail-oriented Claims Adjuster with proven skills in claims evaluation and policy interpretation. Committed to enhancing processes and delivering exceptional customer service.
Overview
24
24
years of professional experience
Work History
Claims Adjuster
Vumi Group
Miami, Florida
01.2018 - 10.2025
- Evaluated insurance claims to determine validity and coverage.
- Reviewed medical records, police reports and other documents related to claim investigations.
- Worked collaboratively with team members across multiple departments; identified areas where processes could be improved.
- Investigated claim details by reviewing reports and interviewing involved parties.
- Communicated with clients to gather necessary documentation for claims processing.
- Trained junior adjusters on company policies and claims handling procedures.
- Maintained accurate records of claim files and correspondence in the system.
Medical Biller and Coder
I Care Cloud
Miami, Florida
10.2014 - 01.2015
- Processed medical claims using advanced billing software.
- Reviewed patient records for coding accuracy and compliance.
- Filed and submitted insurance claims.
electronic data interchange claims
Florida Bracing Center
Margate, Florida
02.2007 - 08.2014
- Reviewed claims for accuracy and completeness according to company policies.
- Processed insurance claims using proprietary software and systems efficiently.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Collaborated closely with team members to achieve project objectives and meet deadlines.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Medical Records Supervisor
The Greater Fort Lauderdale heart group
Fort Lauderdale, Florida
08.2001 - 02.2007
- Managed patient health records in compliance with regulations and standards.
- Supervised medical records staff to ensure accurate data entry and management.
- Developed procedures for organizing and maintaining confidential patient information.
- Trained new employees on best practices in medical records management.
- Collaborated with healthcare providers to resolve discrepancies in patient records.
- Resolved conflicts between physicians regarding discrepancies in patient care documents.
- Performed quality assurance reviews on completed medical records prior to filing them away.
- Investigated complaints from patients about errors or omissions in their medical records.
- Managed the release of protected health information in response to subpoenas or court orders.
- Coordinated with physicians and other healthcare providers to ensure timely completion of medical records documentation.
- Provided guidance on HIPAA regulations related to patient privacy and confidentiality of health information.
- Maintained record of authorized information taken from charts.
Education
Associate Degree Cardiovascular And Ultrasound - Cardiovascular And Ultrasound OB/GYN
Nation School of Technology
Hialeah, FL12-2001
High School Diploma -
American Senior High
Miami, FL05-1997
Skills
- Claims evaluation
- Medical record review
- Claims processing software
- Policy interpretation
- Employee training
- Problem solving
- Attention to detail
- Data entry
- Claims file management processes
- Decision-making
- Problem-solving
- Workflow management
- Record preparation
- Healthcare common procedures coding system (HCPCS)
- Customer service
- Advanced oral and written communication skills
- Empathy and patience
- Claims file documentation
- Team collaboration
Languages
English
Professional
A1
Spanish
Professional
A1
Timeline
Claims Adjuster
Vumi Group
01.2018 - 10.2025
Medical Biller and Coder
I Care Cloud
10.2014 - 01.2015
electronic data interchange claims
Florida Bracing Center
02.2007 - 08.2014
Medical Records Supervisor
The Greater Fort Lauderdale heart group
08.2001 - 02.2007
Associate Degree Cardiovascular And Ultrasound - Cardiovascular And Ultrasound OB/GYN
Nation School of Technology
High School Diploma -
American Senior High