Erin Sullivan
Florence,KY
Summary
Dental operations and product professional with experience in Dental Review Logic, claims administration, dental plan analysis, practice management, and clinical dentistry. Subject matter expert in dental benefits, plan design, claim adjudication logic, CDT coding, and dental policy interpretation. Proven track record of partnering across Claims, Implementation, Product, and Operations to resolve complex issues, improve workflows, support system enhancements, and deliver exceptional customer experiences. Recognized for strong analytical skills, operational leadership, staff development, process improvement, and cross-functional collaboration.
Overview
16
16
years of professional experience
Work History
Dental Review Logic Analyst II
The Guardian Life Insurance Company
07.2021 - Current
- Develop and implement Dental Review Logic within the OpenL database to support cost management initiatives, improve claims accuracy, and enhance customer experience.
- Serve as a subject matter expert for dental policies, claim adjudication logic, plan benefits, and system capabilities.
- Research and resolve complex claims escalations, appealed claims, and benefit interpretation issues through collaboration with cross-functional business partners.
- Execute annual CDT updates based on ADA guidelines and contractual requirements while ensuring operational readiness and compliance.
- Participate in cross-functional projects supporting operational improvements, workflow enhancements, system updates, and customer experience goals.
- Analyze plan requirements and identify opportunities for system enhancements, process improvements, and Dental Review Logic modifications.
- Develop business documentation, testing scenarios, and implementation support materials.
- Provide subject matter expertise to internal stakeholders regarding dental products, claims administration, and benefit design.
Office Manager & Treatment Coordinator
Edge Dental Management
01.2017 - 03.2021
- Directed daily operations for a multi-provider dental practice while maintaining high levels of patient satisfaction, efficiency, and business performance.
- Supervised administrative and clinical support staff, including onboarding, training, coaching, scheduling, performance feedback, and workflow management.
- Led staff meetings and reinforced operational standards, customer service expectations, and office performance goals.
- Developed and implemented standard operating procedures for new and existing locations, improving consistency, operational efficiency, and scalability.
- Trained providers and staff on communication strategies, patient engagement, treatment presentations, and insurance processes.
- Managed employee scheduling and resource allocation to ensure appropriate staffing levels and uninterrupted patient care.
- Presented treatment plans and financial options, improving patient understanding and treatment acceptance.
- Verified insurance benefits, interpreted coverage provisions, submitted insurance claims, and managed appeals.
- Served as a primary escalation resource for patient concerns, insurance issues, and operational challenges.
Registered Dental Hygienist
Edge Dental Management
11.2015 - 12.2016
- Delivered preventive and periodontal care while educating patients on treatment needs, oral health, and preventive care.
- Collaborated with dentists, specialists, and support staff to coordinate quality patient care and treatment planning.
- Maintained compliance with clinical standards, patient documentation requirements, and regulatory guidelines.
- Expanded extensive knowledge of dental procedures, terminology, CDT coding, treatment planning, and clinical rationale.
Office Manager & Registered Dental Hygienist
Today's Dentistry
02.2010 - 10.2015
- Managed all aspects of practice operations, including employee scheduling, payroll administration, staffing coordination, workflow management, and team development.
- Led and mentored clinical and administrative staff, promoting accountability, teamwork, and excellence in patient care and customer service.
- Recruited, trained, onboarded, and coached employees while reinforcing office policies, procedures, and performance expectations.
- Coordinated staff schedules and office resources to maximize operational efficiency and productivity.
- Successfully transitioned the practice from balance billing to time-of-service collections, improving revenue cycle performance and financial outcomes.
- Consistently achieved monthly production and collection goals through operational planning, performance monitoring, and process management.
- Redesigned the patient recare system to improve scheduling efficiency, patient retention, and continuity of care.
- Performed all clinical responsibilities of a Registered Dental Hygienist while serving as an operational leader for the practice.
Education
Associate of Science - Dental Hygiene
Hudson Valley Community College
Troy, NY05-2003
Skills
- More than 20 years of experience leading operational processes, developing teams, improving workflows, and delivering exceptional customer and patient experiences
- Demonstrated success managing, coaching, training, and mentoring clinical and administrative staff while fostering accountability, collaboration, and professional growth
- Experienced creating and implementing standard operating procedures, training materials, and process documentation to promote consistency, scalability, and knowledge transfer
- Proven ability to lead change initiatives, streamline operations, identify process improvements, and drive solutions to complex business challenges
- Trusted partner to cross-functional stakeholders across Claims, Operations, Product, Implementation, Network, and Customer Service functions
- Strong project support and coordination experience with the ability to align stakeholders, resolve issues, mitigate risks, and achieve organizational objectives
Timeline
Dental Review Logic Analyst II
The Guardian Life Insurance Company
07.2021 - Current
Office Manager & Treatment Coordinator
Edge Dental Management
01.2017 - 03.2021
Registered Dental Hygienist
Edge Dental Management
11.2015 - 12.2016
Office Manager & Registered Dental Hygienist
Today's Dentistry
02.2010 - 10.2015
Associate of Science - Dental Hygiene
Hudson Valley Community College