Dj Payne

Dj Payne Email and Phone Number

Quality Assurance Specialist at Custom Design Benefit @ Custom Design Benefits
5589 Cheviot Road, Cincinnati,OH 45247,United States
Dj Payne's Location
Cincinnati, Ohio, United States, United States
Dj Payne's Contact Details

Dj Payne personal email

n/a
About Dj Payne

Dj Payne is a Quality Assurance Specialist at Custom Design Benefit at Custom Design Benefits. They possess expertise in patient advocacy, healthcare, health insurance, managed care, customer service and 14 more skills.

Dj Payne's Current Company Details
Custom Design Benefits

Custom Design Benefits

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Quality Assurance Specialist at Custom Design Benefit
5589 Cheviot Road, Cincinnati,OH 45247,United States
Employees:
71
Dj Payne Work Experience Details
  • Custom Design Benefits
    Quality Assurance Specialist
    Custom Design Benefits Aug 2018 - Present
    Cincinnati, Ohio
  • Humana
    Customer Care Specialist
    Humana Aug 2016 - Aug 2018
  • Quantum Health
    Patient Services Representative/Care Coordinator Lead
    Quantum Health Mar 2009 - Feb 2016
    Columbus, Ohio Area
    ◦Responsible for new employees in harvesting and developing the skills and knowledge needed to be a healthcare warrior. ◦Accept escalated and complex issues regarding billing, claims, medications and plan guidelines. ◦Taking phone calls and/or internet inquiries from patients, families, providers, and employer/client representatives and responding to inquiries regarding benefits, eligibility, claims, network participation, pharmacy, and chronic care/disease management programs.◦Coordinating activities among patients, providers, TPA's, PBM's, and any part affecting the health care of a patient by acting as an advocate for our members as well as assisting them to understand their health care processes and applicable benefits. ◦Completing all necessary referral and pre-certification processes to support the care coordination process.
  • Umr
    Medical Benefits Administrator
    Umr Nov 2006 - Mar 2009
    Cincinnati, Ohio
    •Lead Medical Benefits Administrator for a major hospital system.•Mentor/training of new employees assigned to our account.•Data entry of medical claims.•Answer incoming phone calls from members and providers and responding with appropriate benefits and claims status information.•Administer benefits as plans are written.•Collect and investigate information such as coordination of benefits, Medicare, Medicaid, and clinical appropriateness of services in a timely manner per benefits plan.•Process correspondence within designated time response measures.•Refer cases for Case Management Review or other departmental reviews per guidelines.•Team/paths claims review to assure claims being referred to the medical management team for medical necessity is done so per plan with all medical information attached. •Tiered Network exceptions as clinically appropriate.

Dj Payne Skills

Patient Advocacy Healthcare Health Insurance Managed Care Customer Service Healthcare Management Nursing Data Analysis Hospitals Hipaa Healthcare Information Technology Case Management Disease Management Emr Case Managment Health Education Medicare Insurance Leadership

Dj Payne Education Details

  • Cincinnati School Of Medical Massage
    Cincinnati School Of Medical Massage
    Medical Massage Therapy
  • Scarlet Oaks Joint Vocational School
    Scarlet Oaks Joint Vocational School
    Business Data Processing And Programming
  • St.Bernard-Elmwood Place High School
    St.Bernard-Elmwood Place High School

Frequently Asked Questions about Dj Payne

What company does Dj Payne work for?

Dj Payne works for Custom Design Benefits

What is Dj Payne's role at the current company?

Dj Payne's current role is Quality Assurance Specialist at Custom Design Benefit.

What is Dj Payne's email address?

Dj Payne's email address is dj****@****lth.com

What schools did Dj Payne attend?

Dj Payne attended Cincinnati School Of Medical Massage, Scarlet Oaks Joint Vocational School, St.bernard-Elmwood Place High School.

What skills is Dj Payne known for?

Dj Payne has skills like Patient Advocacy, Healthcare, Health Insurance, Managed Care, Customer Service, Healthcare Management, Nursing, Data Analysis, Hospitals, Hipaa, Healthcare Information Technology, Case Management.

Who are Dj Payne's colleagues?

Dj Payne's colleagues are Mary Gray, Angie Garner, Cindy Fetters, Theresa Kiyan, Jessica Murtha, Michele Stowe, Barb Carmack.

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