Wayne Hampton
About
Detail
Welcome to my profile.
South Carolina, United States
Contact Wayne regarding:
work
Full-time jobs
Starting at
USD25/hour
Résumé
Jobs
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- SMedicare Advocate public Remote experienceSunFireApr 2024 - Current (2 years 6 months)Handled high-volume inbound and outbound calls with professionalism and empathy, serving as a frontline advocate for Medicare and Value-Based Care beneficiaries.
Completed comprehensive Health Risk Assessments (HRA) for dually eligible Medicare D-SNP and C-SNP members, supporting early detection and care planning initiatives.
Seamlessly enrolled eligible members into cost-effective mail-order pharmacy plans through OptumRX and CenterWell, improving medication adherence and member satisfaction.
Generated high-quality leads and scheduled Annual Wellness Visits (AWVs) for Value-Based Care providers, including Oak Street Health, ChenMed, and Conviva, contributing to preventive care goals.
Educated Med 
Customer Service Representative-Third Party Annuities public Remote experienceNew York Life Insurance CompanyJul 2022 - Jun 2023 (1 year)Recruited into a high-impact customer service role supporting third-party annuities, selected for strong communication skills and technical aptitude.
Delivered exceptional multichannel support by handling inbound calls, emails, and live chat to resolve complex customer inquiries with empathy and precision, maintaining a 95%+ satisfaction rating.
Leveraged expertise in rPay to streamline and process policy updates with 100% accuracy, improving workflow efficiency and reducing customer wait times.- Customer Service RepresentativePublic Consulting GroupMar 2019 - May 2021 (2 years 3 months)NJ Division of Aging Services (JACC)
NJ Division of Developmental Disabilities (DDD)
NJ Division of Medical Assistance and Health (PPP/VETS)
Colorado Consumer Directed Attendant Support Services (CDASS)
Florida Participant Direction Option (PDO) - Simply Healthcare
Florida Participant Direction Option (PDO) - Florida Community Care
Florida Participant Direction Option (PDO) - Aetna Better Health of Florida
• • Expedited resolution of Medicaid-based home healthcare inquiries, showcasing proficiency in budgets, authorization, and payroll tax forms, ensuring client satisfaction.
• Maximized outreach effectiveness through proactive follow-up calls while upholding quality assurance standards and serv - Customer Experience Coordinator Provider ServicesClover HealthAug 2017 - Jul 2018 (1 year)• Ensured seamless coverage and resolved claim discrepancies for Clover providers, leveraging Medicare expertise, and enhancing satisfaction and claim accuracy.
• Expertly managed Medicare, fostering trust and satisfaction while spearheading frontline resolution for accurate processing and efficient provider interactions.
• Collaborated cross-functionally to address systemic issues, enhancing provider satisfaction and operational efficiency.
• Proactively identified and escalated care management and claim processing issues, facilitating prompt resolution and service improvement.
• Conducted thorough pre-authorizations, optimizing outpatient services, elective procedures, DME, and medical supplies, ensuring cost-effecti - Customer Experience Coordinator Member ServicesClover HealthDec 2016 - Jul 2018 (1 year 8 months)• Enhanced member experience by promptly addressing inquiries on enrollment, claims, and benefits, ensuring satisfaction and resolution.
• Empowered members with health education, facilitating self-management and resolving escalated tasks efficiently, ensuring comprehensive support.
• Fostered seamless operations through cross-departmental collaboration, meeting diverse customer needs and resolving issues effectively.
• Streamlined in-home assessments by coordinating Nurse Practitioners and Social Workers, optimizing member care and support.
• Facilitated smooth onboarding for new plan members, elucidating benefits and resources, and ensuring informed enrollment decisions.
• Provided adept technical support and trai - Customer Experience Coordinator- Broker Support SpecialistClover HealthSep 2016 - Jul 2018 (1 year 11 months)• Managed inbound calls from the external sales team, resolving service issues promptly, ensuring seamless collaboration, and enhancing agent satisfaction.
• Conducted comprehensive training for brokers on Clover Health’s Medicare Advantage plans, ensuring proficiency and promoting sales effectiveness.
• Delivered technical support and training on the self-service portal, empowering clients and brokers with efficient utilization.
• Optimized agent compensation accuracy and efficiency by processing commissions based on policy sales, enhancing incentive structure and sales performance. - MConductorMTA New York City TransitJun 2014 - Jan 2016 (1 year 8 months)• Safe, timely and proper operation of MTA New York City Transit’s train doors in costumer, yard and work train service
• Opened and closed train doors when in customer service when safe to do so as to prevent customer injury
• Made proper announcements to customers in reference to service changes, transfer points and train destinations and set up the automatic announcement system as well as assisted customers with establishing the most efficient route to their desired destination
• Patrolled platforms as to assist customers in safely entering and exiting trains during rush hour and notify them of service changes
• Operated hand-thrown switches in the yards
• Made reports of unusual occurrences. - MTrain OperatorMTA New York City TransitMar 2013 - Jun 2014 (1 year 4 months)• Safe, timely and proper operation of New York City Transit Authority multi-unit subway cars, subway service cars and trains in accordance with the rules, regulations and special instructions governing such operation
• Prepare trains for road service and switch cars in yards, in revenue road service
• Convey service information to passengers. - HR Connect Customer Information RepresentativeNYC Department of EducationSep 2007 - May 2011 (3 years 9 months)• Facilitated onboarding, certification, and payroll processes for NYC Department of Education personnel, ensuring accuracy and efficiency via in-person and call center support.
• Managed updates of personal and tax data, ensuring compliance and accuracy for NYC Department of Education personnel.
• Acted as Tier 1 specialist for leaves, medical, and health benefits, providing comprehensive support to employees.
• Provided technical support and training for employees and applicants concerning the self-service portal. - GCertified Medicare Coordination of Benefits Specialist-Tier 2GHIEmblemHealthDec 2002 - May 2007 (4 years 6 months)• Determined primary and secondary responsibility for employer group health coverage by researching internal/external data per Federal Medicare guidelines, ensuring accurate claims processing.
• Coordinated benefits with other insurance companies, ensuring accuracy via effective communication and correspondence with members and optimizing claims processing.
• Maintained personal data and insurance payer records in compliance with Federal HIPAA regulations, ensuring data accuracy and confidentiality.
Education
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- SDiploma, General StudiesSpringfield Gardens High SchoolJan 1986 - Jan 1988 (2 years 1 month)