Danielle Sewell
El Dorado,Arkansas
Summary
Insurance and customer service professional with experience supporting dental providers and members through claims research, eligibility verification, policy interpretation, and benefit explanation. Proven ability to investigate claim issues, navigate multiple internal systems, and provide accurate solutions while maintaining HIPAA compliance. Recognized for strong documentation accuracy, problem solving, and the ability to resolve complex inquiries efficiently.
Overview
15
15
years of professional experience
Work History
Dental Customer Service Representative
Mutual of Omaha
07.2025 - Current
- Assisted dental providers and members with questions regarding group dental policy eligibility and benefits. Supported claim determination processes by conducting research on claim activity and policy provisions.
- Evaluated member eligibility, coverage levels, waiting periods, and plan limitations.
- Evaluated dental claim history and conveyed processing outcomes to providers and members.
- Streamlined claim status updates and clarified benefits application for clients.
- Streamlined treatment benefit verification and preauthorization processes for dental offices.
- Evaluated dental procedure codes and insurance guidelines to guarantee precise benefits assessment.
- Executed comprehensive investigations into claim discrepancies, billing inquiries, and provider questions.
- Conducted thorough analysis of documentation and internal records to identify potential processing issues.
- Clarified policy provisions, exclusions, and coverage limitations to enhance client comprehension.
- Documented customer interactions meticulously to uphold HIPAA compliance standards.
- Orchestrated navigation across multiple internal systems to research policies and claim activities.
- Oversaw escalation of complex cases requiring in-depth investigation and internal review.
Registered Dental Assistant
West Rock Orthodontics
09.2016 - 04.2019
- Assisted orthodontists during patient procedures and treatment adjustments.
- Maintained compliance with OSHA sterilization and infection control protocols.
- Documented clinical notes and treatment progress within electronic dental charting systems.
- Prepared patients for procedures and explained treatment steps.
Front Desk Receptionist
West Rock Orthodontics
02.2013 - 08.2015
- Scheduled and coordinated patient appointments and daily office schedules.
- Operated multiline phone system handling appointment requests and patient questions.
- Verified dental insurance benefits prior to treatment.
- Assisted with insurance documentation and claim submission preparation.
- Processed payments and maintained accurate patient account records.
Teller
Smackover State Bank
03.2011 - 01.2013
- Processed deposits, withdrawals, and loan payments.
- Assisted customers with account questions and service requests.
- Balanced daily cash drawer and maintained transaction accuracy.
- Followed federal banking regulations and institutional security policies.
Education
High School Equivalency (GED) - undefined
05.2005
Skills
- Claims Research
- Eligibility Verification
- Policy Interpretation
- Dental Insurance Knowledge
- Provider Relations
- Preauthorization Support
- Claims Status Investigation
- HIPAA Compliance
- Documentation Accuracy
- CRM Systems
- Microsoft Office
- Multisystem Navigation
- Customer Issue Resolution
- Data Entry & Reporting
- Administrative Support
Timeline
Dental Customer Service Representative
Mutual of Omaha
07.2025 - Current
Registered Dental Assistant
West Rock Orthodontics
09.2016 - 04.2019
Front Desk Receptionist
West Rock Orthodontics
02.2013 - 08.2015
Teller
Smackover State Bank
03.2011 - 01.2013