JACQUI PIRL
East Liverpool,OH
Summary
Experienced Dental professional with over 15 years in the dental field. Organized, driven and adaptable with excellent analytical skills.
Overview
13
13
years of professional experience
Work History
Dental Claims Examiner
Miracle Dental Associates
09.2019 - Current
- Reviews and analyzes dental charts, radiographs and progress notes to ensure all procedures are accurate and necessary
- Carefully analyzes procedures to prevent Fraud, Waste and Abuse
- Makes adjustments to claims
- Maintained strong knowledge of basic medical and dental terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Consistently met deadlines, ensuring timely processing of dental claims under high-pressure situations.
- Improved accuracy rates by conducting comprehensive audits on processed claims and implementing corrective actions when needed.
- Achieved cost savings by identifying fraudulent or abusive billing patterns through meticulous analysis of claim data.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Upheld company reputation by adhering to strict ethical standards during all aspects of the claims examination process.
- Maintained confidentiality of patient finances, records, and health statuses.
- Enhanced claim processing efficiency by meticulously reviewing dental claims and verifying patient eligibility.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Managed time efficiently in order to complete all tasks within deadlines.
- Uses Open Dental to upload patient and insurance information
- Submits prior-authorizations to insurance companies with supporting radiographs and documentation
- Securely transfers patient information and/or radiographs with encryption software if needed
- Communicates with Dentists,providers, patients and insurance companies with great professionalism
- Uses SalesForce to track/log equipment and information
- Reviews medical records and other documentation to determine accurateness and appropriateness of services.
- Collaborates with providers and other healthcare staff to ensure the highest quality of care
- Ability to work independently or as part of a team
- Highly organized and great attention to detail
Dental Hygienist
Hudec Dental
04.2016 - 05.2020
- Carried out advanced dental cleaning services.
- Educated patients on importance of oral hygiene and demonstrated techniques for flossing and brushing.
- Exposed, developed, and mounted both intraoral and extraoral dental x-rays.
- Screened patients for signs of oral cancer, lesions, or disease by visually and manually inspecting mouth and gums.
- Administered topical anesthetics to patients' gums to prepare areas being worked on.
- Provided specialized care for pediatric patients, ensuring their comfort during dental visits while fostering healthy habits from an early age.
- Supported office administrative tasks such as answering phone calls, scheduling appointments, and handling insurance billing inquiries when needed.
- Implemented effective infection control measures by sterilizing instruments and following strict protocols for cleanliness.
- Promoted a welcoming environment by maintaining a clean and organized workspace, leading to increased patient satisfaction rates.
- Captured patients' dental radiographs and provided to dentist for interpretation and diagnosis.
- Served as a mentor for new dental hygienists, sharing knowledge and best practices to help them excel in their roles.
- Streamlined appointment scheduling process for better time management and increased overall productivity.
- Sterilized equipment to keep dental tools clean and safe for use, reducing risk of infection.
- Enhanced patient experience by building rapport, addressing concerns, and explaining procedures in a professional manner.
- Participated in continuing education courses to stay current on industry best practices and emerging technologies within the field of dental hygiene.
- Applied fluoride and dental sealants to protect patients' teeth from decay.
- Worked with dentists in developing and implementing personalized care plans for dental patients.
- Assisted dentist with various treatments, ensuring efficient completion of procedures and optimal patient comfort.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Proven ability to learn quickly and adapt to new situations.
- Worked well in a team setting, providing support and guidance.
Dental Hygienist
Refresh Dental
12.2010 - 04.2016
- Capably performed prophylaxis in absence of periodontal disease or gingivitis.
- Applied fluoride and dental sealants to protect patients' teeth from decay.
- Continuously updated professional knowledge through participation in continuing education courses, staying current with industry advancements.
- Collaborated with dental team members to provide comprehensive care for patients, enhancing overall experience.
- Provided exceptional patient care by establishing rapport and addressing anxieties or concerns.
- Took and interpreted X-rays to identify cavities, impacted teeth and other dental issues.
- Coordinated hygiene inventory management by tracking supplies, placing orders and verifying receipt of items.
- Made and confirmed appointments to promote necessary follow-up care to maintain dental health.
- Cared for patients with special needs by providing education related to specific procedures and communicating with caregivers.
- Utilized ultrasonic scaling devices to efficiently remove plaque and calculus buildup from teeth surfaces.
- Sterilized equipment to keep dental tools clean and safe for use, reducing risk of infection.
- Counseled patients on nutritional choices impacting their oral health while developing customized dietary recommendations based on individual needs.
- Developed individualized treatment plans to address specific patient needs and concerns.
- Implemented infection control protocols to maintain a safe and hygienic environment for both patients and staff.
- Screened patients for signs of oral cancer, lesions, or disease by visually and manually inspecting mouth and gums.
Education
Associate of Applied Science - Dental Hygiene
West Liberty University
West Liberty, WV05.2008
Skills
- Utilization management
- Fraud-Waste-Abuse
- Expertise in dental codes, procedures and terminology
- Prior authorization processing
- Claims review and processing
- Attention to Detail
- Task driven and goal oriented
- Excellent written and oral communication
Timeline
Dental Claims Examiner
Miracle Dental Associates
09.2019 - Current
Dental Hygienist
Hudec Dental
04.2016 - 05.2020
Dental Hygienist
Refresh Dental
12.2010 - 04.2016
Associate of Applied Science - Dental Hygiene
West Liberty University