Dylan Boyd Email and Phone Number

Research Asst. to Prof. Y.S. Lee, focus on Law and Development, International Trade Law

• Analyzed, reviewed and appropriately applied health plan benefit provisions for major medical and prescription drug claims while adhering to the group’s plan, applicable state statutes, ERISA regulations, ACA requirements, etc.• Played key role in implementation of new managed care plans when company pivoted away from fully insured health plans• Independently identified claim system inadequacies or other claim related issues and initiated a resolution • Appropriately interpreted physician group and hospital network contracts and applied correct fee schedule• Identified opportunities for medical cost containment procedures for all forms of health plan benefits, included gathering of documentation for review of appropriate billing practices• Gathered and organized relevant medical documentation to review for appropriate medical management and when necessary, physician review of medical necessity and appropriate standards of care• Identified high dollar/catastrophic claim files, coordinate with Case Management Review and gather information to determine possible subrogation opportunities • Provided high levels of customer service to members, employers, providers, agents, attorneys and administrators via written, verbal and face to face interactions