Doracy Wheeler

Receive and process orders from patients and providers via phone. Ensure patient demographics is up to date. Delegate calls to proper entities when required. Process orders within insurance guidelines. Knowledge of DME including but not limited to- ostomy, urology, wound care, and diabetic supplies. Address general patient inquiries/concerns. Identify and resolve order issues. Provide general guidance and assistance to less experienced team members.

Promoted internally from Customer Service Representative to Provider Services Representative during tenure with the organization. Initially supported member-facing healthcare accounts and was later selected to work directly with provider offices and hospitals, assisting with denied claims, medical document review, and claims resolution support.

· Reviewed and documented medical records and claim information

· Coordinated claim follow-up with providers and internal departments

· Ensured accuracy, compliance, and confidentiality standards

· Buckeye Community Health plan

· Provider Service Representative

Promoted internally from Customer Service Representative to Provider Services Representative during tenure with the organization. Initially supported member-facing healthcare accounts and was later selected to work directly with provider offices and hospitals, assisting with denied claims, medical document review, and claims resolution support.

· Reviewed and documented medical records and claim information

· Coordinated claim follow-up with providers and internal departments

· Ensured accuracy, compliance, and confidentiality standards

· Buckeye Community Health plan

· Provider Service Representative

Processed Medicare account setup and provider selection requests using established procedures. Reviewed eligibility information and coverage details to support accurate plan. Recorded and maintained detailed documentation for healthcare-related accounts. Ensured compliance with privacy standards and internal policies.