Da'Joun Willingham Email & Phone Number

Virginia Beach, Va, Us

Wellesley Hills, Massachusetts, Us

Conducted detailed research and analysis of dental codes to determine eligibility and requirements for claim approvals and pre-authorizations.Evaluated documentation to ensure compliance with insurance guidelines, identifying missing information or discrepancies to expedite approval processes.Communicated effectively with providers and dental offices to clarify claims requirements, resolve discrepancies, and provide status updates.Coordinated case management for complex claims, ensuring timely resolution and adherence to policy standards.Reviewed and interpreted various dental insurance plans, fee schedules, and reimbursement policies to ensure accurate claim adjudication.Provided insights on reimbursement trends and policy updates to improve claim processing accuracy and efficiency.Maintained up-to-date knowledge of dental procedures, codes (e.g., CDT), and insurance policies to provide expert guidance on claims.Collaborated with internal teams to refine authorization workflows, reducing processing time and increasing provider satisfaction.Delivered detailed explanations of benefits (EOBs) to providers and patients, ensuring transparency in reimbursement calculations.

Roseland, New Jersey, Us

• Managed 6-12 concurrent IT projects, leading system implementations and serving as a key liaison between front-end and back-end developers to translate client requirements into technical solutions tailored to their companies’ specific needs.• Conducted in-depth system analysis to identify business needs, optimize workflows, and ensure smooth integration of new systems with existing infrastructures. • Led weekly client meetings to provide updates, discuss system enhancements, gather feedback, and address any technical or functional concerns. • Resolved project challenges, including budget constraints, technical issues, and timeline adjustments, while ensuring alignment with project goals and deadlines.• Collaborated with upper management in weekly meetings to report on project progress, identify resource requirements, and discuss potential risks that could impact project delivery. • Provided hands-on assistance to back-end development teams, troubleshooting complex issues, and contributing to database design • Participated in system testing, prototyping, and quality assurance, ensuring that new systems met both functional and performance standards.• Assisted with data migration, including balancing prior vendor and tax data with new system frameworks, identifying data discrepancies, and working directly with clients to resolve issues.• Conducted payroll data validation, ensuring that tax and payroll outputs from the new system were accurate and compliant with regulatory requirements. • Performed rigorous end-to-end testing and debugging to ensure a stable and scalable system for long-term client use. • Identified opportunities for system improvements and upsold clients on additional features or services to maximize system efficiency and performance. This version emphasizes your role in system analysis, hands-on IT back-end assistance, and strategic technical decision-making.

Chevy Chase, Md, Us

• Consistently excelled in handling a high volume of 80-105 daily calls, engaging with diverse customer types, from first-time homeowners to seasoned investors, and providing tailored insurance solutions based on their specific needs.• Expertly overcame objections and concerns on the phone, using active listening and persuasive communication skills to educate customers on the benefits of comprehensive coverage options, leading to higher conversion rates. • Maintained a detailed call-back and follow-up data sheet, tracking customer interactions, policy interests, and future sales opportunities, which contributed to fostering strong customer relationships and closing long-term sales. • Specialized in selling a wide range of insurance products, including flood, earthquake, jewelry, and special property protection, while effectively upselling and cross-selling policies to maximize customer protection and satisfaction.• Licensed in multiple states and proficient in navigating various insurance regulations and requirements, ensuring seamless service across diverse regions and coverage needs.• Led training sessions for new hires, providing hands-on coaching on handling different customer personalities, overcoming objections, and closing sales, which resulted in improved team performance. • Facilitated sales floor meetings to boost morale and refine sales techniques, encouraging a collaborative environment focused on achieving sales targets.• Participated in meetings with upper leadership, providing strategic feedback to enhance sales processes and suggesting innovative ideas to streamline customer management and sales workflows. • Transitioned into managing and testing key IT projects, collaborating with cross-functional teams to streamline several internal programs and software systems used in daily business operations, making processes more efficient for both sales and customer service teams.

Indianapolis, Indiana, Us

Evaluate and Prepare Authorizations: Review pharmacy authorization requests to ensure accuracy, completeness, and compliance with regulatory and organizational standards prior to review.Clarify Denial Reasons: Analyze and interpret denial decisions, identifying discrepancies or missing information, and provide clear, concise explanations to stakeholders.Provider Communication: Collaborate with healthcare providers to address authorization issues, obtain additional documentation, and ensure timely processing of requests.Patient Support: Serve as a point of contact for patients, explaining the status of their authorizations and assisting with alternative options when necessary.Regulatory Compliance: Stay up to date with pharmacy and insurance policies, guidelines, and procedures to ensure adherence to industry regulations.Documentation: Maintain accurate records of all authorizations, communications, and outcomes in compliance with privacy and confidentiality standards (e.g., HIPAA).Process Optimization: Identify trends or recurring issues in authorization workflows and recommend process improvements to enhance efficiency and service quality.Problem-Solving: Act as a liaison to resolve escalated issues between pharmacy teams, insurance providers, and patients, ensuring a seamless experience.Team Collaboration: Work closely with multidisciplinary teams, including case managers and pharmacists, to ensure alignment and consistency in handling requests.Customer-Focused Communication: Provide empathetic and professional interactions with all stakeholders to promote patient satisfaction and trust.

• Sold time slots to artist and upsold packages to boost profits and time.• Worked closely with frequent customers, Labels and Managers to always ensure that projections were met for the month• Orchestrated contacts with Record labels to also fill time slots and create revenue even when the studio was not being used• Maintained studio equipment • Updated software as recommended hardware updates to ensure efficiency • Proposed upgrades based on information gathered by many sources • Created Data charts and stored information for presentations

Associate'S Degree, Computer Science

Certificate, Project Management

High School Diploma, General Studies