Dawn Hoyle

Contract Administrator / Service Manager

dawn.hoyle@mail.com | 850.496.3020

MY BACKGROUND CAREER HISTORY

Customer Service Management experience with
sustained results and effective change for various Christian Care Ministry (Medi-Share)
platforms of customer service roles. Major experience Provider Contract Administrator | Aug 2018-Current
lies in strong leadership and leading by example to
bring about customer experience change and Managed the writing, implementation and maintaining of Medi-Share provider Contracts, Single Case
Agreements, and Letters of Agreements.
improvement in strategy, process, and customer
Subject matter expert of Medi-Share guidelines and processes.
satisfaction – both as a leader and expert consultant.
Analyze and evaluate current PHCS Network gaps based on the exclusions list.
Manage collaboration with leadership to research network opportunities.
Assist leadership with all provider communication.
SOFTWARE PROFICIENCY
MS Office Humana Inc.
Facets Provider Services Consultant | Sept 2016-Dec 2017
Citrix
Cognos Author Reporting Contract Management: Renegotiated and executed Humana Medicare HMO Contracts with a
CC Pulse 99% success rate resulting in improved collaboration on meeting strategic objectives.
Kronos and Oracle Stop Loss Project: Saved company $350K annually by identifying high cost members and
Peoplesoft obtaining appropriate documentation to move applicable claims to the stop loss fund.
Workday
Quality Management: Consulted with over 50 Physicians on key performance indicators driving
PBX Systems-command Center
improvements to the overall quality of healthcare provided in the Market.
SQL
Managed authorization process for over 50 assigned Physicians and provided ongoing referral
SharePoint
system training for over 250 clinical associates.
Carebook
Responsible for monitoring and managing the implementation of over 40 process
CCP2
CGX improvement projects for the FL Panhandle Network.
Availity
Paag Ascension/Sacred Heart Medical Group
PMDM Medical Office Secretary | Mar 2016-Sep 2016
PFP
Managed audit of former patient charts to be scanned and uploaded into Electronic Medical
PROFESSIONAL SKILLS Records. Worked with outside vendor to ensure that charts were properly prepared and
download into EMR.
Advanced knowledge of HEDIS Managed new patient data for multi- doctors, as well as all aspects of customer service within
ICD-10 Coding the department. Submitted daily reports to management.
Excellent communication skills Compiled and gathered information to re-credential existing providers and mid-level
Data collection and analysis providers, as required by insurance companies.
Decision-making
Project planning Blue Cross Blue Shield of TN
Organizing tasks, data, and human resources Customer Service Supervisor/Benefit Rep TTE/ Consumer Advisor | Sept
Strategic/Analytical thinking
Team Building 2004-Sept 2015
Individual Development of staff
Directed and coordinated daily task for a customer service call center with a team of more
Creative and innovative
than 30 consumer advisors of which six were telecommuters.
Managed and maintained a $350,000 budget annually with my last 2 years being under budget
by $60k each year.
Decreased the volume of errors received on inbound customer service calls through the
implementation of additional quality sampling programs and ongoing one-on-one coaching.
Motivated employees to achieve personal goals and consistently meet established
performance goals.
Developed staff training programs and reference manuals for new trainees.