DOMINIQUE DESIDERIO
Staten Island,NY
Summary
Detail-oriented and motivated patient care coordinator with a strong foundation in medical insurance, claims processing, and billing practices. Possesses a solid understanding of revenue cycle management, regulatory compliance, and insurance adjudication, complemented by exceptional administrative and customer service skills. Proficient in utilizing healthcare software systems such as Epic, Cerner, and MediSoft to streamline claims and billing operations.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Claims Representative
Allstate
01.2023 - 01.2024
- Executed a variety of claims management responsibilities, ensuring correct processing, review, and resolution of insurance claims in alignment with company policies and state regulations
- Processed and evaluated high volumes of claims with 98% accuracy, ensuring timely settlements and customer satisfaction
- Communicated with policyholders, adjusters, and other stakeholders to resolve disputes, clarify coverage details, and provide transparent status updates
- Investigated claim validity through detailed analysis of documentation, policies, and external information to mitigate risks and prevent fraud
Care Coordinator
PlushCare
01.2021 - 01.2022
- Liaised between patients, healthcare providers, and insurers to address inquiries, clarify policies, and expedite services with a 95% resolution rate
- Implemented quality assurance measures and contributed to achieving organizational benchmarks and patient care goals
- Ensured compliance with HIPAA, state, and organizational regulations through meticulous documentation and data management
- Scheduled and managed medical appointments, follow-ups, and treatments, improving systems such as Epic, Cerner, and Meditech to support accurate documentation
- Facilitated and monitored comprehensive care plans, supporting diverse patient populations through personalized case management
Customer Service Representative
SYKES
01.2021 - 01.2022
- Delivered exceptional customer service by resolving inquiries, managing accounts, and providing tailored solutions to meet individual client needs
- Demonstrated strong interpersonal communication skills and technical proficiency to ensure optimal customer satisfaction in high-volume environments
- Responded to customer inquiries across various channels, including phone, email, and live chat, maintaining an average resolution time of under 24 hours
- Resolved escalated complaints with empathy and professionalism, upholding a customer satisfaction rating of 95%
- Harnessed CRM platforms such as Salesforce, Zendesk, and HubSpot to track and document customer interactions, achieving a 98% data accuracy rate
Medical Assistant
Northwell Health
01.2019 - 01.2021
- Collected and documented vital signs, medical histories, and laboratory specimens with 100% accuracy using EHR platforms such as Epic and Cerner
- Scheduled and coordinated patient appointments, referrals, and follow-ups, effectively reducing scheduling errors by 15%
- Educated patients on treatment plans, medication instructions, and wellness practices to improve health outcomes and compliance rates
- Coordinated and executed patient care services in a fast-paced clinical environment, ensuring high-quality healthcare delivery through meticulous attention to detail and advanced administrative support
Education
Medical Insurance Specialist/Medical Biller Certificate -
Institute of Career College
New York, NY03.2021
Medical/Clinical Assistant Certificate -
San Joaquin Valley College
Visalia, CA04.2012
Skills
- Billing specialist
- Quality assurance
- Time management
- Self management
- Conflict resolution
- Medical terminology understanding
- Documentation proficiency
- Healthcare operations
- Claims processing
- HIPAA compliance
- Critical thinking
- Patient relations
- Electronic medical record software
- Performance metrics
- Medicare compliance
- Health information systems
- Records maintenance
Certification
- Medical Insurance Specialist/Medical Biller Certificate
- Medical/Clinical Assistant Certificate
Timeline
Claims Representative
Allstate
01.2023 - 01.2024
Care Coordinator
PlushCare
01.2021 - 01.2022
Customer Service Representative
SYKES
01.2021 - 01.2022
Medical Assistant
Northwell Health
01.2019 - 01.2021
Medical Insurance Specialist/Medical Biller Certificate -
Institute of Career College
Medical/Clinical Assistant Certificate -
San Joaquin Valley College
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