Customer Service Billing Specialist

Dwayne Fyne

**** ***** ******* *** (***) *** - **08

Woodmere, NY 11598 ******@*****.***

Objective

A highly motivated and creative individual with proven ability to multi-task and to handle various projects while meeting the required deadlines. Is seeking a position where my strengths can be utilized and the company can benefit from my many abilities, including my strong technical, interpersonal and organizational skills.

Professional Experience

Claims Adjustment/Billing Specialist (Remote) New York, New York United HealthCare System January 2022 - Present

Complete necessary adjustments to claims and ensure the proper benefits are applied to each claim using the appropriate processes and procedures

Adjust existing monetary values on claims and statements based on provider, hospital or designated facility itemized charges

Reconcile all claims and billing in accordance with company standard operating procedures

Audit financial statements and electronic documents with applicable laws, financial policies and regulations

Ensure timely payments to providers, members and their representatives

Maintain working knowledge of medical codes, and billing procedures with continuous training modules monthly

Communicate to providers and members via electronic portal upon reconciliation of adjusted claims or accounts Patient Care Support (Business Associate) New York, New York New York Presbyterian Hospital October 2010 - January 2022

Interface with Nurses and Doctors On Neuroscience unit to fulfill daily care objectives of all patients

Using hospital computer system and applications (Excel, Word, MS dos)resume to input and discharge patients seamlessly

Solve various issues that arise on a given unit associated with patient care and equipment needs

Interface with hospital admitting department to solve documentation issues regarding patient insurance & admittance

Responsible for the appropriation/allocation of unit budget associated with unit business administration needs

Point of Contact for families, Doctors, Nurses, And outside facilities to solve complex non healthcare related issues

Provide excellent customer service to patients and their families with hospice or end of life care needs Help Desk/Comp. Tech New York, New York

A.I.G. December 2005 – November 2006

Computer workstation and printer network troubleshooting, Supporting staff of over 30 workstations

In charge of office network facilities, including: making sure the copiers and printer network framework is operational

Maintain inter office computer intranet communication system

Above average computer proficiency, Networking, Computer construction/Maintenance, Power-point, Microsoft Office, Excel, Adobe, Microsoft Suite applications

Mt Sinai Hospital, New York, New York

Nurse Assistant (NA) November 2006 - December 2010

Handle Clients’ confidential and sensitive information on a daily basis

Assist in overall Out Patient Department operations, to ensure efficiency and productivity

Trained to attain daily vital sign evaluations and monitoring of all patients on floor

Work side by side with unit nurses in attaining patient vitals and knowing their whereabouts

Entering patient vital signs in hospital computer system as directed

Knowledge of hospital policies and procedures

Provide excellent and efficient customer service for the development of rapport with clients Rockaway Development Corp., New York, New York

Site Supervisor July 1999 – August 2005

General Overseer of worksites (15)

Settled disputes between workers and employees, ages 12 - 21

Weekly travel to D.O.E.(dept. of employment) for administrative documentation

Responsible for payment of workers at sites/Timesheets/Scheduling payments EDUCATION

G.W. Hewlett High School New York, NY

High School Diploma Graduated 1999

Roberts Wesleyan College Rochester, NY

B.A. Business Administration Graduated 2004

Skills And Abilities:

Proficient in Microsoft Word, Excel, PowerPoint, IoT proficiency, Cyberlink Suite, Adobe, After effects, Cloud Computing, Community advocate and open source project contributor. Deadline oriented, positive work ethic, effective time management, lauded customer and personal service skills, multi- tasker, complex problem solver, strong organizational skills, dependable, management of personnel resources, excellent interpersonal skills, team player, able to adapt quickly in multiple environments and conditions

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