DeJaun Hagler

I am a dedicated healthcare and insurance professional with experience in medical assisting, claims advising, and insurance. I support patient care, handle medical claims, explain insurance coverage options, and deliver exceptional customer service in fast-paced healthcare and insurance settings.

In my most recent role as a Claims Adjudicator II, I reviewed and adjudicated medical claims in accordance with health insurance policies, benefit plans, and regulatory guidelines. I processed claims using HRP, Epolicy, NPPES NPI Registry, Citrix, Smart front end, Healthedge source, and Medcompass, while performing eligibility verification, prior authorization review, and resolving complex claim exceptions.

Earlier, as a Health Benefit Representative, I verified member eligibility and coverage and supported prior authorization requests by reviewing documentation and coordinating with providers and internal departments. I’ve also generated business as a Life Insurance Producer, building long-term client relationships through consultative sales and ongoing policy reviews, while maintaining compliance with ethical and confidentiality requirements.