Summary
Overview
Accomplishments
Work History
Education
Skills
Timeline
Generic
Caley Ridge

Caley Ridge

Rossville,IN

Summary

My objective is to secure a challenging and dynamic professional environment where I can actively contribute to the ongoing evolution and advancement of dental insurance benefits. I am particularly passionate about championing fair practices that ensure success for all. Furthermore, I aim to be a vital resource, offering essential guidance, education, and support to dental professionals, empowering them to deliver the highest quality of care and navigate the complexities of modern dental healthcare. I am recognized for my proactive approach to identifying, addressing, and resolving issues with payors.



Overview

16
16
years of professional experience

Accomplishments

    My success in identifying and rectifying errors within various insurance companies' processes. These corrections prevented further incorrect claim processing and ensured appropriate reimbursement for dental offices.

Work History

Head of Operations

Lucky Penny, LLC
01.2020 - Current
  • Provide Client Practice Analysis to pinpoint inefficiencies, missed billing opportunities, underutilized resources, and areas where value is being delivered but not adequately monetized.
  • Enhanced customer satisfaction by addressing complex insurance-related issues and inquiries, resolving issues promptly, and provide advice on new insurance contracts
  • Complete Credentialing/Re-Credentialing applications per Clients Requests
  • Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
  • Resolved discrepancies in insurance payments by collaborating with carriers and appeals
  • Trained new hires on company policies and procedures, ensuring a seamless transition into the Insurance Specialist role.
  • Managed all insurance verification services and insurance billing services for clients
  • Trained office staff team on insurance communications to patients

Dental Insurance Biller - Team Lead

Insurance Billing Outsourcing
04.2019 - 01.2020


  • Minimized billing errors through regular auditing of patient records, identifying inaccuracies, and implementing corrective measures promptly.
  • Improved cash flow for the dental practice by expediting submission of clean claims to insurance carriers.
  • Train Employees to meet each specific client needs
  • Expedited appeals process when necessary through comprehensive documentation support, improving likelihood of favorable outcomes.
  • Maintained up-to-date knowledge of dental insurance regulations and coding practices, ensuring accurate billing processes.
  • Monitor and track clients KPIs and audit all work being provided to clients
  • Effectively manage and meticulously oversee all phases of client onboarding, ensuring a seamless and positive experience from initial contact through full integration
  • Served as the primary point of contact for all client inquiries

Office Manager

First Impressions Family Dental Care
11.2016 - 04.2019
  • Worked for the Chairman of the Council on Dental Benefits within the Indiana Dental Association, which included tasks such as but not limited to; resolved all issues between IN dentists and insurance companies, advocate for fair practices, provided valuable resources and support to dentists, provided assistance in plan development, analyzed dental benefit contracts, and assisted the person who has a crucial role in helping shape the landscape of dental benefits
  • Required insurance companies to pay all benefits they are responsible for through appeals, phone call follow-up and discussions with Payor Relations,
  • Provided exceptional customer service when addressing patient inquiries or concerns via phone calls, in person, or email communications.
  • Maintained accurate financial records by auditing/reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
  • Managed all dental claim submission, follow-up ad payment posting
  • Developed comprehensive policy manuals outlining procedures and guidelines, contributing to a well-organized workplace culture.

Treatment Coordinator

Periodontal Specialists of IN
08.2011 - 10.2016
  • Managed approximately 50 incoming communications, including phone calls, faxes and emails
  • Completed Levine Group Consulting Seminar The Successful 21st Century Practice and The Case Presentation Makeover
  • Directed all marketing initiatives and managed correspondence with referring dentists.
  • Maintained detailed records of patient treatments, ensuring accurate billing and efficient followups.
  • Increased case acceptance rates through persuasive presentation of treatment options and benefits.
  • Implemented data-driven decision-making processes, utilizing analytics to optimize operational efficiency.
  • Managed patient and insurance accounts receivable.
  • Submitted insurance claims, estimates, and narratives.
  • Assisted in surgical procedures and maintained sterile environments for instruments and patient rooms.
  • Provided patients with comprehensive pre-operative and post-operative instructions.
  • Maintained office cleanliness and managed inventory and procurement of supplies.
  • Managed the opening and closing procedures of the practice.
  • Collaborated with executive leadership on strategic planning initiatives to drive business growth.

Sales Associate

Stride Rite Retail Store
09.2009 - 04.2012
  • Built relationships with customers to encourage repeat business.
  • Measured children's feet included assessing length, width, and arch type to ensure the selection of appropriately sized footwear.
  • Tried shoes on children's feet and felt foot inside the shoe for proper fit
  • Managed returns, exchanges and refunds in accordance with store policy.
  • Helped customers locate products and checked store system for merchandise at other sites.
  • Assisted in training new staff members on company policies, product information, and sales techniques for a seamless onboarding experience.

Catalog Distribution Processor

Consultant Depot
08.2009 - 07.2011


  • Taped and labeled catalogs for mail delivery
  • Bundled catalogs in accurate bundles by zip code for correct mail distribution
  • Picked up all supplies, catalogs, and mailing labels
  • Delivered all catalogs to Post Office in proper trays depending on location by specified mailing dates for proper distribution

Education

Expanded Duties Dental Assistant -

Dental Office Training
Fishers, IN
04.2011

High School Diploma -

Westfield Washington High School
Westfield, IN
11.2010

Skills

  • Data analysis and tracking
  • Strong attention to detail
  • Problem-solving skills
  • Rectifying Inaccuracies
  • Payor contract and fee schedule negotiations
  • Client account management
  • Professionalism and ethics
  • Business analysis
  • Operational excellence
  • Customer service
  • Effective communication
  • Teamwork and collaboration

Timeline

Head of Operations

Lucky Penny, LLC
01.2020 - Current

Dental Insurance Biller - Team Lead

Insurance Billing Outsourcing
04.2019 - 01.2020

Office Manager

First Impressions Family Dental Care
11.2016 - 04.2019

Treatment Coordinator

Periodontal Specialists of IN
08.2011 - 10.2016

Sales Associate

Stride Rite Retail Store
09.2009 - 04.2012

Catalog Distribution Processor

Consultant Depot
08.2009 - 07.2011

Expanded Duties Dental Assistant -

Dental Office Training

High School Diploma -

Westfield Washington High School

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