Customer Service Medical

Gary Dunlap

630-***-**** • ***********@*****.*** • www.linkedin.com/in/gary-dunlap-3187b738/

Profile

Strategic Professional with 20+ years of progressive experience in identifying opportunities for improvement and implementing solutions which enhance quality, contain cost, and maximize efficiency. Adept Leader & Communicator skilled in building rapport and collaborating with diverse partners and mobilizing team members in support of project and organizational goals. Core competencies in:

Leadership • Customer Service • Project Management • Research & Analysis • Training • Process Improvement • Problem Resolution • Quality Assurance (QA) • Public Speaking • Collaboration

Highlighted Experience

CVS/Caremark • Various Locations • 2003-Present

Field Conversion Support Team Specialist Pittsburgh, PA • 2014-2018

Member of team of 40 support team specialists charged with converting newly acquired, nationwide sites to SPARCS/HBS claims processing and order management systems.

Serve as SPARC/HBS subject matter expert, providing technical assistance, troubleshooting, and individual training.

Execute production support in benefits verification, order shipment, and patient communication.

Selected Accomplishments:

Transitioned 7 sites during merger [Memphis, Troy (MI), Raleigh, Tampa, Redlands 9 (CA), Milford (MA), Fairfield(NJ)].

Implemented and recommended process improvements including daily communication/debriefing practices.

Insurance Accounts Receivable Specialist (Back End) Chicago, IL • 2003-2012

Administered 500+ individual (patient) accounts with receivables totaling over $1M.

Conducted systemic research on denials and claims.

Analyzed accounts for insurance payment accuracy against contract terms.

Generated technical reports (e.g. accounts receivable tracking, communication, sales tax/write offs, claim denials).

Partnered with 20+ payers encompassing commercial, major medical, pharmacy, Medicare part D and various state Medicaid plans (e.g. Humana, Prime Therapeutics, Aetna, United Healthcare, Argus) to resolve claim issues.

Selected Accomplishments:

Identified and resolved major payer issues with 20+ at-risk accounts with billed amounts of $10,000+; collaborated with external payers, internal management and Billing to ensure consistent payment of claims within 30 days of submission.

Processed approximately 100 medical claims per day with a 95%+ accuracy rate.

Regularly selected to complete special projects, resolving unusual cases valued at $100K-500K.

Additional Experience

Benefits Verification Specialist (Front End) CVS/Caremark • Pittsburgh, PA • 2013-2014, March 2017 to present

Insurance Accounts Receivable Specialist CVS/Caremark • Pittsburgh, PA • 2012-2013

Medical Claims Processor & Customer Service Unicare Life & Health • Greensboro, NC & Chicago, IL • 1997-2003

Education

BA, Organizational Communication University of North Carolina at Greensboro • Greensboro, NC

Professional Development

Team Management & Leadership Training Program Landmark Education Corporation • Chicago, IL

High Impact Leadership Staub Peterson Leadership (now Staub Leadership, International) • Oak Ridge, NC

Contact this candidate