Dawn Jacobs Email & Phone Number

New York, United States

Leading teams for product and plan benefit configuration, plan documents and enrollment.

Configuration of Javelina claims system categories, plans and adjudication logic. Build and maintain workflow queue rules and flow.

Buffalo, New York, United States

As the first associate at an ambitious startup TPA, I wore many hats. - Managed Compliance and Core System Configuration- Implemented Javelina claims system- Configured Javelina claims system- Configured MESA member, HR and provider portal- Onboarded new associates, set up automated onboarding processes, created job descriptions and configured the HR.

Amherst, NY

Worked closely with IT department on implementing a new claims processing system. Tested, identified and resolved processing issues. Developed and prepared training materials.

Amherst, NY

Implemented and trained staff on a quantitative interview method. Conducted interviews,hiring and terminations. Developed, marketed and implemented North American University training programs to educate employees on all aspects of the business.

Amherst, NY

Provided direction, support and leadership to Claims Analysts and Supervisors. Developed leadership skills of Supervisors and staff to respond to department needs. Communicated with client on a daily basis to ensure timely and proper adjudication of claims.

Amherst, NY

Trained new Claims Analysts over a 6 week program. Utilized audit data to determine on going training needs and delivered training to address deficits. Received DDI (Development Dimensions International) Trainer Certification. Delivered and developed Management Training.

Amherst, NY

Reviewed processed claims for quality assurance. Evaluated accuracy of analysts application of company wide claims processing guidelines, SPD’s across various employers/insured groups, and interpretation of claim data (Provider type, ICD-9, CPT codes).

Amherst, NY

Processed claims, according to multiple plan guidelines, analyzing CPT and ICD-9 codes. Managed inbound customer service phone calls.