Dianne Karla

Managed various facets of Provider and Payer RCM and third-party contributors, including inbound, outbound, and back-office accounts. Pioneered several healthcare accounts in Manila and Kenya, encompassing both US and PH accounts such as remote care monitoring and AR billing.

Led 6 team leaders and SMEs, overseeing 20-24 FTEs per team in an inbound medical insurance provider service. Responsible for daily operations, including eligibility, benefits, and claim status inquiries, while also managing capacity planning and hiring for the program.

Managed the daily operations of an inbound order management LOB for durable medical equipment. Led 3 team leaders and 9 escalation advocates, overseeing approximately 90 customer service advocates, and was responsible for staffing and scheduling.

Oversaw daily operations for an inbound provider medical insurance program, focusing on eligibility, benefits, and claim status. Led 10 team leaders and 3 SMEs, managing approximately 180 customer service advocates, and collaborated with the Workforce team to ensure optimal staffing.

Acted as operations manager, team lead, QA, and trainer for a pioneer dental program, responsible for hiring and managing 15-24 agents. Developed individual development plans, conducted coaching sessions, and handled payroll.

Facilitated basic skills training, including American grammar, culture, and customer service, as well as product-specific and cross-training for multi-skilled agents. Launched a pioneer medical health insurance program and assisted operations by taking calls and updating training materials.

Assisted members in understanding their dental insurance plans, submitting claims, and locating accredited providers. Also helped dental providers understand customer insurance benefits and answered inquiries regarding reimbursement payment processes.

Pursued a Bachelor of Arts degree with a major in Organizational Systems Development within Behavioral Science. Gained knowledge in understanding human behavior, organizational structures, and system development principles.