Manuel Chaidez
Monterey Park
Summary
Results-driven Provider Payment Resolution Specialist with four years of experience in healthcare call center operations, claims resolution, and provider support at IEHP. Excel at managing high-volume inquiries, identifying process improvements, and collaborating cross-functionally to achieve organizational goals, seeking to advance into leadership or project management roles within healthcare.
Overview
11
11
years of professional experience
Work History
Provider Payment Resolution Specialist
IEHP
Rancho Cucamonga
05.2025 - Current
- Deliver high-level customer service to providers and vendors, resolving complex payment disputes.
- Investigate provider issues, review medical documentation and contracts, and present actionable findings in escalated claims meetings.
- Create, monitor, and close service tickets to ensure timely provider updates and compliance.
- Identify claim trends and recommend operational process improvements that support organizational goals.
Provider Call Center Representative
IEHP
Rancho Cucamonga
11.2021 - 05.2025
- Handled high-volume inbound calls, providing accurate information on claims, authorizations, and policy inquiries, while consistently exceeding QA standards (90%+).
- Analyzed claim data, communicated resolutions professionally, and ensured thorough documentation and follow-up.
- Led daily team huddles, collaborated with management on escalated issues, and supported UM inquiries.
- Maintained excellent schedule adherence and contributed to team performance metrics.
Property and Casualty Surveyor
Property and Casualty Surveys
San Dimas
04.2015 - 11.2021
- Independently managed inspection routes, schedules, and inventory across the Los Angeles territory in a fully remote role.
- Reviewed technical documentation, ensured compliance with underwriting standards, and delivered detailed reports to insurance carriers.
- Demonstrated strong organizational skills and consistent on-time delivery in a fast-paced, autonomous environment.
Insurance Broker
Freeway Insurance
Los Angeles
12.2014 - 04.2015
- Advised clients on auto, home, and commercial insurance options, tailoring policies to individual needs and budgets.
- Trained new agents on sales techniques, compliance requirements, and customer service best practices.
- Achieved high client retention through proactive follow-up and relationship-building.
Education
Bachelor Of Science (BS) - Business Administration
Westwood College
Anaheim, CA05-2011
Skills
- Provider relations and payment resolution
- Data analysis, trend identification, and reporting
- Process optimization and service ticket management
- Microsoft Office Suite (Excel, Word, PowerPoint)
- Facilitate daily huddles and cross-department collaboration
- Problem-solving, strategic thinking, and time management
Additional Experience & Leadership
- Competed in high school water polo and trained karate for 7 years
- Warehouse logistics and forklift operations experience
Timeline
Provider Payment Resolution Specialist
IEHP
05.2025 - Current
Provider Call Center Representative
IEHP
11.2021 - 05.2025
Property and Casualty Surveyor
Property and Casualty Surveys
04.2015 - 11.2021
Insurance Broker
Freeway Insurance
12.2014 - 04.2015
Bachelor Of Science (BS) - Business Administration
Westwood College