Kandy Raguskus

Work History

Manager of Insurance and Payor Operations in a Dental Support Organization (DSO)

Dentsply Sirona, Byte

08.2020 - Current

Developed and maintained strategic relationships with insurance providers and payors to negotiate favorable contract terms, ensuring competitive reimbursement rates for the organization
Established best practices for handling insurance claims and payor negotiations, ensuring alignment with industry standards and compliance requirement
Directed claims management processes to ensure timely and accurate claim submissions, which reduced delays and minimized denials and rejections
Designed and implemented comprehensive workflows for the insurance operations team, ensuring standardized and efficient processes across claims management, billing, collections, and insurance verification which reduced administrative error, and improved overall operational efficiency
Increased productivity 20% through streamlining workflows while leading a staff of 18
Developed and implemented partnerships with insurance companies, increasing our in-network participation
Spearheaded a 21% increase in revenue by negotiating new contracts with insurance providers
Implemented policies and procedures for insurance verification, billing, and collections, which streamlined workflows, reduced administrative errors, and improved overall operational efficiency
Collaborated with executive management and clinical teams to align treatment plans with insurance guidelines, ensuring optimal reimbursement while maintaining high-quality patient care
Provided leadership and mentoring to staff with training on insurance processes such as claims submission, denial management, and contract negotiations to elevate team performance
Led revenue cycle management effort, implementing strategies to enhance collections, reduce accounts receivable aging, and optimize cash flow, directly improving the financial health of the organization
Built and led a high-performing insurance operations team, providing comprehensive training and development that enhanced staff productivity and significantly reduced handling times
Developed and implemented comprehensive training and onboarding programs for a Business Process Outsourcing (BPO) team, ensuring new hires had the knowledge and skills to succeed from day one
Simultaneously led and managed offshore and onshore teams, fostering seamless collaboration across time zones, driving operational alignment, and maintaining high-performance standards across both teams

Business Development Manager

ChamberWest

08.2019 - 03.2020

Fostered relationships with community leaders, area businesses, and stakeholders to promote economic growth and development within the community
Developed and executed business development strategies to attract new businesses, enhance membership growth, and retain existing members
Managed the chamber’s membership program, including recruitment, onboarding, and retention efforts

Orthodontic Treatment Coordinator/ Front Office Coordinator

Northwest Orthodontics, Dr. Vonny Ngantung

04.2017 - 06.2019

Streamline patient scheduling process, reducing wait times, and improving patient satisfaction
Presented treatment options and financial plans to patients, addressing any concerns, and explaining payment options, including insurance coverage and payment plans
Oversaw insurance verification and billing processes, effectively communicating with insurance companies to resolve claims, expedite payments, and reduce claim rejections
Provided exceptional customer service, creating a welcoming environment for patients and families while addressing concerns and questions

Orthodontic Treatment Coordinator/Orthodontic Dental Assistant

Magic Smiles – Dr. Phil Doleac

11.2000 - 04.2017

Built strong patient relationships, contributing to high patient retention and referrals
Increased treatment acceptance rates by effectively presenting treatment plans and financial options to patients
Collaborated with dentists and clinical staff to communicate clearly and guide patients throughout their treatment journey
Managed and coordinated orthodontic treatment plans by scheduling patient appointments, ensuring seamless communication between patients, clinical staff, and orthodontists
Presented comprehensive treatment options and financial plans to patients, including detailed breakdowns of costs, insurance benefits, and payment plans, facilitating informed decision-making
Delivered exceptional patient care and customer service, fostering a welcoming and supportive environment, addressing concerns, and ensuring patients felt informed and valued throughout their treatment

Summary

Overview

Work History

Manager of Insurance and Payor Operations in a Dental Support Organization (DSO)

Business Development Manager

Orthodontic Treatment Coordinator/ Front Office Coordinator

Orthodontic Treatment Coordinator/Orthodontic Dental Assistant

Education

Dental Assisting -

Skills

Certification

Software

Timeline

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