Summary
Overview
Work History
Education
Skills
Health Care Profile
Volunteer Experience
Hobbies and Interests
Timeline
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BRITTON THIBODEAUX

BRITTON THIBODEAUX

Youngsville,LA

Summary

Motivational leader and organizational problem-solver with advanced supervisory, team building and customer service skills. Experience stepping into roles and quickly making positive changes to drive company success. Focused on using training, monitoring and morale-building techniques to maximize employee engagement and performance. Personable and dedicated Customer Service Representative with extensive experience in the insurance industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.

Overview

20
20
years of professional experience

Work History

Director of Revenue and Insurance Strategies

Texas Dental & Braces Dental service or
San Antonio , TX
05.2023 - Current
  • Developed and implemented pricing strategies to maximize revenue growth.
  • Collaborated with sales and marketing teams to ensure optimal pricing of products and services offered.
  • Managed the forecasting process in order to set appropriate goals for maximum profitability.
  • Provided guidance on best practices in revenue management processes to staff members within the organization.
  • Established policies and procedures related to revenue management operations.
  • Negotiated agreements with external partners such as contractors or consultants.

Senior Network Recruitment Specialist - Team Lead

DELTA DENTAL INSURANCE COMPANY
Rancho Cordova , CA
08.2017 - 05.2023
  • Provider Contracting for all Nationwide Government plans; Medicare Advantage group contracting, Legion FEDP and CCN contracting, and Medicaid for our CDPHP NY Network
  • Managed recruitment project for CDPHP Medicaid program upstate NY state.
  • Bimonthly Legion FEDVIP and CCN Serving and Availability call campaigns
  • CDPHP Quarterly GEO Access report – Medicaid, HARP, Essential plans, and CHIP
  • Speaker for VA CCN webinars online and in-person
  • Key Achievements: Recipient of the first Recruitment award in DDIC Government programs - Gold Individual Recruitment award for Government programs 2018

Network Development, Texas State Medicaid, and Government Programs

BLUE CROSS BLUE SHIELD OF TEXAS
Austin , Texas
02.2012 - 01.2017
  • General Practice and Specialty Contracting for the Travis County Service Area and surrounding Texas areas
  • TX Health and Human Services Quarterly reporting for GEO Access
  • Strategic Network development of new Medicaid Programs associated OB
  • Received high grades on Network Provider surveys
  • Serviced the largest number of counties in the BCBSTX Medicaid provider network
  • Key Achievements: Served as OB/GYN and CHIP Perinate Subject Matter Expert (SME) pertaining to network development with large clinic group practices and IPAs, competition, and growth opportunities
  • I contracted the highest amount of providers in my team.

Medical Coder and Billing Specialist, Texas State Medicaid, Medicare and Commercial Medical Insurance

ESCAN DATA SYSTEMS
Austin , Texas
01.2010 - 01.2012
  • Worked many operational functions to achieve reduction of uncompensated care, converting accounts to Medicaid.
  • Assisted in the development of coding guidelines and policies.
  • Ensured timely resolution of denials due to incorrect code assignments or missing information in the claim form.
  • Conducted periodic audits to ensure that all submitted claims were accurate and met the criteria for reimbursement.
  • Collaborated with medical staff to determine appropriate coding for services rendered.
  • Processed appeals on denied claims in a timely manner to maximize reimbursements from third-party payers.
  • Generated invoices for services rendered according to established guidelines.

Orthodontic Assistant

JOSEPH PORTER, DDS
Baton Rouge , Louisiana
01.2008 - 01.2010
  • Assisted orthodontist in clinical activities such as taking impressions, fitting bands, and placing arch wires.
  • Organized patient records and kept track of treatment plans.
  • Performed chairside duties including preparation of trays and passing instruments to the doctor during procedures.
  • Made impressions of teeth for mouth guards and other oral fixtures.
  • Analyzed customer accounts to identify discrepancies and resolve billing issues.

Orthodontic Assistant, Treatment Coordinator, Invisalign Specialist, Laboratory Technician

WESLEY ARDOIN, DDS
Lafayette , Louisiana
01.2004 - 01.2008
  • Fabricated orthodontic appliances from wax impressions, models and prescriptions.
  • Collaborated closely with dentists to ensure optimal outcomes for patients.
  • Prepared financial statements for review by the orthodontist or office manager.
  • Ensured that all necessary paperwork was completed accurately prior to treatment.
  • Assisted with month end closing procedures related to accounts receivable activities.
  • Prepared daily deposits of payments received from customers.

Orthodontic Assistant

RICHARD MANNESS, DDS
Lafayette , Louisiana
01.2006 - 01.2007
  • Assisted orthodontist in clinical activities such as taking impressions, fitting bands, and placing arch wires.
  • Verified insurance coverage for prospective patients prior to treatments being rendered.
  • Processed payments for services rendered accurately and efficiently.
  • Supported administrative tasks such as filing documents, updating medical records.
  • Developed digital impressions of teeth using specialized software programs.
  • Motivated and encouraged team members to communicate more openly and constructively with each other.

Education

Acadiana Career College

Some College (No Degree) -

Louisiana School of Dentistry

Medical and Dental Coding Billing Specialist -

Academy of Healthcare Professions

Skills

  • Providing network servicing support to providers
  • Fee negotiation expert
  • Provider/Client Presentations
  • Maintains Large group relationships through efficient communication
  • Claim Research & Resolution
  • Comprehensive Knowledge of Competitors and Market Trends
  • Contracting and credentialing master
  • Large group servicing efforts
  • Proficient in Microsoft Excel – Pivot tables, and data analytics
  • Cost Analysis
  • Staff Management
  • Requirements Gathering
  • Configuration Management
  • Employee Management

Health Care Profile

Knowledgeable, articulate communicator with 20 years of customer care experience across the healthcare industries. Maintains strong business relationships with problem-solving abilities, as well as excellent customer service experience.

Volunteer Experience

BCBS of TEXAS, February 2012 - 2017, Blue Bear Mascot, 20 events to date Blue Bear's community outreach efforts include visits to children's hospitals, community events, charitable events, and immunization outreach events.

Hobbies and Interests

  • Gardening
  • Painting
  • Cooking
  • Zumba
  • Music Enthusiast
  • Chorus singer
  • Marathon Kids annual events
  • Mother of two exceptional humans
  • Texas Mission of Mercy Events (TMOM) 2017-2023

Timeline

Director of Revenue and Insurance Strategies

Texas Dental & Braces Dental service or
05.2023 - Current

Senior Network Recruitment Specialist - Team Lead

DELTA DENTAL INSURANCE COMPANY
08.2017 - 05.2023

Network Development, Texas State Medicaid, and Government Programs

BLUE CROSS BLUE SHIELD OF TEXAS
02.2012 - 01.2017

Medical Coder and Billing Specialist, Texas State Medicaid, Medicare and Commercial Medical Insurance

ESCAN DATA SYSTEMS
01.2010 - 01.2012

Orthodontic Assistant

JOSEPH PORTER, DDS
01.2008 - 01.2010

Orthodontic Assistant

RICHARD MANNESS, DDS
01.2006 - 01.2007

Orthodontic Assistant, Treatment Coordinator, Invisalign Specialist, Laboratory Technician

WESLEY ARDOIN, DDS
01.2004 - 01.2008

Acadiana Career College

Some College (No Degree) -

Louisiana School of Dentistry

Medical and Dental Coding Billing Specialist -

Academy of Healthcare Professions
BRITTON THIBODEAUX