Driven to promote customer satisfaction through personalized and knowledgeable support for different requirements. Self-directed in investigating and resolving inquiries. Demonstrated skills in meeting and surpassing productivity targets.
Overview
18
18
years of professional experience
Work History
Practice Manager
Tina Morehart D.D.S.
Oklahoma City, OK
07.2022 - 09.2023
Maintained financial records, including billing and accounts receivable and payable.
Monitored compliance with OSHA and HIPAA regulations.
Conducted regular meetings with staff to discuss operational issues and ensure proper communication between departments.
Coordinated staff recruitment, training, and scheduling activities.
Provided leadership and guidance to the team in order to meet goals and objectives.
Oversaw all aspects of day-to-day practice operations including front desk reception, appointment scheduling, billing and coding, insurance verification, treatment planning and financial arrangements.
Practice Manager
Jason Wallace D.D.S.
Nicoma Park, OK
04.2018 - 04.2021
Assisted with new practice start up in Nicoma Park, OK.
Maintained financial records, including billing and accounts receivable and payable.
Coordinated staff recruitment, training, and scheduling activities.
Credentialed provider with PPO and medicaid insurance companies.
Conducted fee negotiations with PPO insurance companies.
Oversaw all aspects of day-to-day practice operations including front desk reception, appointment scheduling, billing and coding, insurance verification.
Resolved escalated patient issues in a timely manner while maintaining a high level of professionalism.
Supported entire practice's staff, which boosted efficiency and improved overall process flow.
Owner
Professional Credentialing Services of N.A.
Fort Worth, TX
12.2015 - 01.2018
Reviewed and processed credentialing applications to ensure accuracy, completeness, and compliance with all accreditation standards.
Validated primary source documents such as licenses, diplomas, certifications and other related credentials.
Performed initial review for new providers to determine eligibility for enrollment into the network.
Ensured timely completion of credentialing processes by providing guidance to providers on required documentation.
Participated in periodic audits of credentialing files to maintain compliance with applicable regulations and policies.
Processed re-credentialing applications for existing providers according to contractual requirements.
Interacted regularly with representatives from health plans and commercial payers regarding credentialing matters.
Set up NPI numbers for providers and facilities and updated current profile information.
Provider Relations Representative
MCNA of North America
Fort Worth, TX
07.2013 - 12.2015
Developed and maintained strong relationships with providers by responding promptly to inquiries, resolving issues and providing ongoing support.
Assisted providers in understanding their contractual obligations and ensured timely resolution of any discrepancies or disputes.
Conducted site visits to evaluate current processes used by contracted providers including medical record review and quality assurance measures.
Coordinated internal training sessions on topics such as coding updates, claims processing guidelines.
Collaborated with other departments within the organization to resolve complex issues related to provider relations activities.
Maintained accurate records of all communications with providers including emails, letters, phone calls.
Responded quickly and effectively to complaints from contracted providers regarding payment issues or other matters.
Attended conferences and seminars focused on healthcare industry trends that may affect provider relations activities.
Cultivated strong relationships to maintain provider network knowledge and implement corrective actions for ongoing issues.
Reviewed complex and unusual claims to determine coverage restrictions.
Practice Manager
My Dentist, Inc.
Fort Worth, TX
02.2006 - 10.2012
Coordinated staff recruitment, training, and scheduling activities.
Maintained financial records, including billing and accounts receivable and payable.
Assessed medical office operations, identified areas of improvement, and developed plans for corrective action.
Provided leadership and guidance to the team in order to meet goals and objectives.
Conducted regular meetings with staff to discuss operational issues and ensure proper communication between departments.
Monitored compliance with HIPAA regulations concerning patient privacy rights.
Created reports that tracked key performance indicators such as revenue growth and efficiency metrics.
Oversaw all aspects of day-to-day practice operations including front desk reception, appointment scheduling, billing and coding, insurance verification.
Implemented policies and procedures related to patient care delivery in accordance with organizational standards.
Resolved escalated customer service issues in a timely manner while maintaining a high level of professionalism.
Participated in strategic planning initiatives aimed at developing long-term goals for the practice's growth and success.
Supported entire practice's staff, which boosted efficiency and improved overall process flow.
Facilitated implementation of new technology systems into existing workflows in order to improve operational efficiency.
Created customized treatment plans for patients based on individual needs.
Conducted financial counseling sessions for new and existing patients.
Education
High School Diploma -
Trinity High School
Euless, TX
05.1990
1990-1992
Tarrant County College District
Fort Worth, TX
2006-2008
University of Phoenix
Oklahoma City
Skills
Workflow Management
Policy and Procedure Development
Records Management
Quality Assurance
Claims Resolution
Complaint Investigation
Managing Practice Operations
Work Preference
Work Type
Full Time
Work Location
RemoteHybrid
Important To Me
Career advancementCompany CulturePaid sick leave401k matchStock Options / Equity / Profit SharingWork from home optionHealthcare benefitsWork-life balancePaid time offTeam Building / Company RetreatsPersonal development programs