Dawn Fitzgerald

Key Responsibilities

• Client Consultation & Education
• Explain dental plan options, coverage details, and exclusions.
• Assist clients in selecting plans that meet their needs and budget.
• Provide guidance on preventive care benefits and cost-saving strategies.
• Plan Enrollment & Administration
• Process new enrollments, renewals, and plan changes accurately.
• Maintain compliance with company policies and regulatory requirements.
• Keep accurate client records and documentation.
• Claims Assistance
• Help clients understand claim procedures and resolve issues.
• Liaise with dental providers and insurance carriers to expedite claims.
• Compliance & Regulatory Knowledge
• Stay updated on dental insurance regulations and industry standards.
• Ensure all advice and actions comply with HIPAA and other applicable laws.
• Customer Service & Relationship Management
• Respond promptly to inquiries via phone, email, or in person.
• Build long-term relationships to encourage plan retention and satisfaction.
• Reporting & Analysis
• Track enrollment trends and provide feedback to improve plan offerings.
• Prepare reports on client interactions and plan performance.
• Cross-Selling & Upselling
• Identify opportunities to offer additional coverage (vision, orthodontics, etc.).
• Educate clients on bundled benefits for cost efficiency.
• Assisted in resolving member inquiries to enhance service delivery and satisfaction.
• Collaborated with teams to streamline documentation processes and improve accuracy.

Responsible for the tracking, coordination and communication of patient referrals in the work queue. Collaborate with practices to ensure completed and accurate patient registration, demographics and current insurance.

Assembles information concerning patient's clinical background in EPIC to help with referral Contacts insurance companies to ensure verification of benefits and prior authorization approval requirements are met via web ro telephone.

Collaborate with Practice Manage to get clinician to perform a peer-to-peer for approval/prior authorizations for a collaborate with social workers if patients have potential issues related to financial or social barriers

Ensures that referrals are addressed in a timely matter and meeting metric goals for urgent vs non-urgent referrals.

• Managed electronic health records, ensuring accuracy and compliance with healthcare regulations.
• Coordinated with insurance companies for accurate billing and claim processing, reducing errors and financial discrepancies.
• Fostered strong relationships with referral sources for increased network connections, benefiting both the clinic and its patients through expanded resources.

• Coordinated patient referrals to ensure timely access to specialty services.
• Managed communication between patients and healthcare providers, enhancing care continuity.
• Streamlined referral processes, reducing wait times for appointments and consultations.
• Developed and maintained referral tracking systems to monitor patient progress.
• Collaborated with medical staff to resolve complex referral issues promptly.
• Provided training for new team members on referral protocols and procedures.
• Analyzed referral data to identify trends and improve operational efficiency.
• Led initiatives to enhance patient education about the referral process and available services.
• Called insurance companies to get precertification and other benefits information on behalf of patients.
• Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
• Verified insurance benefits and eligibility for [Type] procedures before referring clients.
• Promoted clear communication between primary care providers and specialists through detailed documentation and follow-up calls.
• Built professional relationships with service providers.
• Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
• Scheduled appointments with specialists on behalf of clients.
• Obtained prior authorization for [Type] procedures.
• Enhanced patient satisfaction by promptly addressing inquiries and resolving issues related to referrals.
• Ensured continuity of care by regularly updating patient records with recent test results or changes in medical history.
• Identified opportunities for process improvements within the referral department, leading to increased efficiency and accuracy.
• Acted as a liaison between referring physicians and specialists, establishing trust and rapport through professionalism.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.

• Managed inventory control and medication distribution processes to ensure accuracy and compliance.
• Trained new technicians on pharmacy systems and procedures, enhancing team efficiency and knowledge.
• Oversaw prescription processing, verifying patient information and medication accuracy for safety.
• Implemented workflow improvements that reduced processing times and increased customer satisfaction.
• Led initiatives to streamline communication between pharmacy staff and patients, enhancing service delivery quality.
• Answered incoming phone calls and addressed questions from customers and healthcare providers.
• Stocked, labeled, and inventoried medication to keep accurate records.
• Completed paperwork, entering prescription and insurance or billing information into patient profiles.
• Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
• Increased customer satisfaction by delivering friendly, personalized service during transactions.
• Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
• Maintained accurate inventory levels for efficient pharmacy operations and cost control.
• Counted, measured, and compounded medications following standard procedures.
• Assisted in preparation, distribution and storage of pharmaceuticals.
• Communicated directly with doctors offices via telephone, fax and email.
• Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
• Contributed to improved patient adherence by providing clear medication instructions and addressing concerns or questions promptly.
• Performed regular audits to maintain compliance with state regulations and company policies.
• Maintained drug inventory levels by ordering necessary medications and supplies.
• Assisted customers with over-the-counter product selection, providing knowledgeable recommendations.