Kathleen Sicilia
Creighton,PA
Summary
Proven Insurance Specialist with a track record of enhancing customer satisfaction and reducing claims processing time at Timothy J. Sluser, DMD. Skilled in policy analysis and account management, adept at resolving complex insurance claims and streamlining financial processes. Demonstrates strong documentation skills and a commitment to regulatory compliance, contributing to significant team performance improvements.
Knowledgeable Dental Auditing with solid foundation in Dental insurance policies and risk assessment. Successfully managed client portfolios and resolved complex claims, ensuring client satisfaction and compliance with industry standards. Demonstrated proficiency in policy analysis and client communication.
X-ray certified and excellent in reading x-rays and knowledgeable with Dental terms including all aspects of tooth numbers, periodontal conditions and treatment planning. Several years of experience in all aspects of the dental field
Overview
10
10
years of professional experience
1
1
Certification
Work History
Insurance Specialist
Timothy J. Sluser, DMD
04.2021 - Current
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Resolved discrepancies in insurance payments by collaborating with carriers.
- Reduced claims processing time by effectively collaborating with adjusters, claimants, and internal departments.
- Communicated effectively with members of operations, finance, and clinical departments.
- Contributed to team performance by sharing industry knowledge and assisting colleagues in complex cases.
- Expedited resolution of disputed claims through effective negotiation with claimants, attorneys, or third-party carriers.
- Maintained organized records of all claims and communications.
- Reviewed insurance claims for accuracy and completeness.
- Investigated claims by gathering relevant evidence and statements.
- Assisted clients in understanding coverage and claim procedures.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Followed up with customers on unresolved issues.
- Upheld a high level of accuracy by consistently double-checking figures, data entries, calculations, before finalizing any settlement documents or payments.
- Developed a strong knowledge of various insurance products to provide comprehensive guidance during the claims process for diverse clientele.
- Conducted detailed investigations into complex insurance claims to establish liability, contributing to more informed decision-making.
Financial Coordinator/Dental Insurance Specialist
Integrated Periodontics and Associates
07.2015 - 04.2021
- Maintained filing systems for financial documents and reports.
- Organized and scheduled meetings to discuss financial strategies and updates.
- Collaborated with team members to streamline financial processes.
- Reviewed invoices and processed payments according to company policies.
- Explained insurance benefits, fees and procedures to patients.
- Contacted insurance carriers to discuss policies and individual patient benefits.
- Submitted claims to insurance companies on same day as patient treatment.
- Monitored account balances and alerted management of any issues.
- Managed daily financial transactions and maintained accurate records.
- Answered questions over phone and in-person regarding billing, scheduling and treatment.
- Oversaw invoicing processes, ensuring prompt billing of clients/vendors while minimizing errors in calculations or account entries.
- Supported executive decision-making by providing detailed financial analyses upon request.
Education
Certificate of Technical Studies - Dental Lab Technician
Median School of Allied Health Careers
Pittsburgh, PA12-1981
Skills
- Documentation skills
- Policy analysis
- Account management
- Regulatory compliance
Certification
Dental x-ray Certified
Timeline
Insurance Specialist
Timothy J. Sluser, DMD
04.2021 - Current
Financial Coordinator/Dental Insurance Specialist
Integrated Periodontics and Associates
07.2015 - 04.2021
Certificate of Technical Studies - Dental Lab Technician
Median School of Allied Health Careers
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