Dwayne Fields

• Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions. Dedicating to providing quality customer service, verifying benefits claims, moving to the appeals department, responding to correspondence follow up, and resolving Issues, Include Credentialing
• Responded proactively and positively to rapid change.
• Educated customers about billing, payment processing and support policies and procedures.
• Increased efficiency by accurately entering provider data into company systems and databases.
• Maintained up-to-date knowledge on company products, services, and industry trends to provide accurate information to providers.
• Implemented innovative tools within call center environment which boosted overall productivity of provider services team while maintaining high level of customer satisfaction.

• Performed evaluations of competitor
• Checked employees' benefits enrollment for accuracy and inputted all data into [Software].
• Researched and evaluated new benefits programs to select cost-effective providers and coverage levels.
• Served as primary point of contact for employee benefits inquiries, resolving issues promptly and accurately.
• Coordinated and managed all aspects of annual benefit plan renewals-ensuring a seamless transition for employees while minimizing disruption to ongoing operations.
• Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.

• Conducted regular performance reviews for team members, identifying areas for improvement and offering constructive feedback.
• Led a team focused on resolving complex customer issues, resulting in improved satisfaction ratings across all channels.
• Assumed ownership over team productivity and managed work flow to meet or exceed quality service goals.
• Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
• Evaluated employee performance and conveyed constructive feedback to improve skills.
• Set aggressive targets for employees to drive company success and strengthen motivation.

Answered Heavy inbound calls (40+ daily) and incoming calls from patients about their medical health care plans. Handled claim calls daily. Ensured accurate data input and ensured all relevant customer information was filed correctly. Always maintained polite and courteous mannerisms with customers. Carried out data entry and multi-line phone system tasks Performed customer and client retention.

Verify patient's health information using medical records Use MRN to access patient's medical records. Verify and update patient's billing information. Work within various specialties (Pediatric, Pediatric specialties, OB/GYN, GYN, Internal medicine, Internal medicine specialties, Cardiology, Radiology, Tai chi, Pulmonary, Ophthalmology, Orthology) Verify patient's test results Confer with nurses and doctors through written correspondence Contact emergency doctors within a timely manner Contact various pharmacies verifying and refilling patient's RX prescriptions Verify patient's insurance and cross-referencing that information with the correct corresponding doctor