Dinanda Chenevert Email & Phone Number

New Orleans, La, Us

New Orleans, La, Us

Metairie, Louisiana, United States

• Direct and mentor a team of 30+ customer service personnel, processing 6,000 inbound calls weekly.• Evaluate daily reports from Cisco Unified Intelligence to ensure staff utilization and occupancy rates met optimal levels, resulting in a 20% increase in operational efficiency.• Establish routine meetings with account leaders to review team performance and KPI’s driving accountability and efficiency in meeting client service level agreements (SLAs). • Pioneer strategies to mitigate member escalations linked to enrollment, COB, pharmacy rejections in Rx claims; measured a 20% increase in customer satisfaction scores.• Initiate product-specific chat rooms to elevate team members’ product understanding and communication proficiency, produced a 30% increase in first call resolution rates.• Partner with training department to assess unit requirements, integrate new procedures; optimize workflow and reduce turnaround time for client deliverables, enhancing overall operational efficiency.• Maintain productive relationships with outsourced vendors, serving as a single point of contact, to ensure seamless collaboration and optimize service reliability.

Metairie La

• Led and coached a team of Provider Service Advocates to deliver exceptional service and maintain productive relationships with network providers based on mutual respect, trust, and shared goals.• Conducted quarterly one on one meetings with staff to review performance and quality metrics.• Assisted in the credentialing process of network providers by communicating re-credentialing requirements, facilitating the submission of required documents, and providing status updates. • Drove cross-functional collaboration to address issues with key providers surrounding claims processing, billing errors and portal access leading to a 30% reduction in provider complaints.• Monitored provider compliance with plan policies and procedures as outlined in the contract.• Devised complex research, analyzed data, and generated necessary reports to senior leadership for tracking and priority establishment of revenue cycle barriers affecting 50% of high-profile clients.• Developed visual job aids for staff assisting hospice providers with billing inquiries related to primary payer responsibility for services that involve revocation.• Implemented dispute resolution workshops to equip staff with conflict resolution techniques.

Baton Rouge, Louisiana Area

• Supervised 15-20 intake coordinators processing level 1 authorizations for inpatient medical and surgical admits based on InterQual criteria and referring to level 2 and 3 when needed.• Served as SME to staff making benefit determinations and processing authorizations for outpatient diagnostic services, labs and DME.• Managed the ACD system in conjunction with WFM to monitor live calls, minimize staff downtime and reduce call average handle time (AHT) by 2 minutes.• Forged a connection with third party vendors related to service delivery for ASO groups and workload distribution for PSYCH and CDU admissions. • Led initiatives to enhance staff engagement and motivation through performance incentives based on monthly adherence metrics and quality scores with “Lunch & Learn” sessions for specialized training.• Conducted in-depth analysis using professional coding skills and Facets claims expertise to resolve over 50+ complex authorization issues for providers with high utilization rates.• Executed compliance monitoring for URAC and Mental Health Parity, presented policy updates in weekly staff meetings and staged mock audits to evaluate adherence.• Secured $500K in funding for the successful implementation of WFM technology resulting in a 25% increase in operational efficiency. • Spearheaded the ideation process and proposed innovative solutions regarding authorizations to the Jiva project team during daily planning sessions, driving a 15% increase in project efficiency.