James McPhatter
Oceanside,CA
Summary
Cultivates, nurtures and maintains long-term customer relationships to boost sales and grow brand visibility. Account Manager accomplished in managing customer service for numerous top accounts while simultaneously exceeding sales goals on new and existing products. Exceptional Account Executive with solid background of success in meeting annual sales objectives and increasing overall client base. Career history of penetrating new accounts, opening new territories and expanding existing business. Expert in consultative selling techniques. Constantly looks for new ways to promote products and build professional network ties.
Overview
16
16
years of professional experience
Work History
AT&T Field Sales Rep/Sales Account Manager
AT&T Communications
Escondido
01.2020 - Current
- Handled highest volume of wireless sales in the territory, generating more than $1.1 million in revenue.
- Managed a diverse portfolio of accounts, ensuring each client received personalized attention and support.
- Increased sales revenue by identifying and pursuing new business opportunities.
- Adhered strictly to departmental guidelines; ensured that all activities were compliant with applicable state laws.
- Maintained accurate documentation of all claim activity within designated system.
- Utilized computer systems such as Microsoft Office Suite and specialized software programs used by the company.
- Analyzed sales data to identify areas of improvement in sales strategies.
- Directed sales force in achieving daily, monthly, and annual sales goals.
- Monitored performance targets and sales metrics of sales team to monitor productivity.
- Created sales reports that tracked daily, weekly, and monthly sales figures.
Dental Claims Processor
La Costa Family Dental
Carlsbad
01.2019 - 01.2020
- As a dental office manager, I lead new hire and continued education training, manage doctor schedules, supervise dental office staff respond to doctor and patient inquiries manage patient scheduling and payment schedules
- Prepared insurance claim forms, explained benefits, and outlined pricing details for procedures and services.
- Effectively resolved patient concerns or complaints, maintaining excellent client relations and promoting ongoing customer loyalty.
- Boosted dental practice revenue by optimizing billing procedures and diligently following up on outstanding payments.
- Maintained strict confidentiality of all patient records, ensuring compliance with HIPAA regulations and safeguarding sensitive personal information.
- Identified coding errors on claims and worked with providers to correct them in order to avoid delays in payment.
- Maintained knowledge of current dental industry trends, including changes in regulations, coding systems, reimbursement policies.
- Analyzed medical records to determine whether services were medically necessary according to established criteria.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Organized information by using spreadsheets, databases or word processing applications.
Oral Surgery Assistant
West Coast Dental
Los Angeles
01.2009 - 01.2019
- As a traveling Perio/Oral surgery assistant I performed duties to assist Specialist Doctors with patient care and administrative functions
- Assisted surgeon during procedures by wiping up bodily fluids and handing over needed dental instruments.
- Minimized complications during surgery by effectively monitoring anesthesia levels under the guidance of an Oral Surgeon or Dental Anesthesiologist.
- Maintained accurate documentation of all claim activity within designated system.
- Reviewed medical records, police reports and other documents related to claim investigations.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Resolved claim disputes through mediation and negotiation, minimizing the need for litigation.
- Interpreted insurance policy language to apply appropriate coverage.
- Conducted witness interviews to assist claim information gathering process.
Oral Surgery Assistant
Interdent
Los Angeles
01.2012 - 01.2013
- Prepared surgical area by ensuring that all necessary dental instruments were sterilized and patients were ready.
- Maintained a safe and clean working environment through proper sterilization of instruments and adherence to infection control protocols.
- Provided high-quality pre-surgical consultations, discussing potential risks, benefits, and alternatives with prospective patients.
- Provided assistance in training new staff members as needed.
- Analyzed physician's reports, hospital records, laboratory results, operative reports, diagnostic tests. to assess medical necessity of services rendered.
- Verified accuracy of provider data entered into the system including tax ID numbers, NPI numbers, address changes .
- Calculated payments due based on allowed charges compared to billed charges according to contract terms with payers, insurers, third parties.
- Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
- Reviewed claims for accuracy before submitting for billing.
- Administered standard contract benefits to process pending claims for dental benefits.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
Education
Bachelors of Arts – Business information systems - Management Information Systems
University of Phoenix
Murrieta, CA01.2014
Associates of Arts- General studies -
University of Phoenix
01.2012
Hospital Corpsman Certification; Periodontics And Oral Surgery Training -
Naval Medical Center
Skills
- Client Relationship Building
- Claims Handling and Coverage Verification
- Risk Assessment
- Claims Processing
- Advanced computer skills
- Database Management
- Sales background
- Caseload Management
- Legal Compliance
- Claims investigations
- Policy Interpretation
- Report Writing
- Insurance Claim
- Medical terminology knowledge
- Customer Service
- Account management expertise
- Effective Communication
- Coverage Determination
Timeline
AT&T Field Sales Rep/Sales Account Manager
AT&T Communications
01.2020 - Current
Dental Claims Processor
La Costa Family Dental
01.2019 - 01.2020
Oral Surgery Assistant
Interdent
01.2012 - 01.2013
Oral Surgery Assistant
West Coast Dental
01.2009 - 01.2019
Bachelors of Arts – Business information systems - Management Information Systems
University of Phoenix
Associates of Arts- General studies -
University of Phoenix
Hospital Corpsman Certification; Periodontics And Oral Surgery Training -
Naval Medical Center