Kathleen Young
Pine Grove,PA
Summary
Experienced in managing dental office operations and resolving quality of care issues, with strong analytical and communication skills. Skilled in records management, HIPAA compliance, and customer service. Eager to contribute as a Quality of Care Coordinator by leveraging leadership and problem-solving abilities to enhance patient satisfaction and operational efficiency.
Overview
1
1
Certification
25
25
years of professional experience
Work History
Quality Care Coordinator
Delta Dental
Mechanicsburg, PA
08.2022 - Current
- As a Quality of Care Coordinator, I am responsible for conducting critical analysis and responding to quality of care and service complaints and potential quality referrals for all lines of business. I oversee the complaint response process to facilitate timely resolutions and responses.
- Recording all quality of care and quality of service complaints and potential quality referrals initiated by members and internal and or external clinicians and determines whether complaint is administrative or clinical in nature.
- Reviewing clinical and dental records for completeness reaches out to provider if record is incomplete and builds the case for review by the Dental Consultant.
- Performing research and identifying key policy provisions such as clinical guidelines plan policies EOC regulatory guidelines and DMHCDHCS rules and regulations that may apply to the complaint or referral.
- Summarizes cases including articulation of complainants perception and presents essential information to Dental Consultant for review.
- Assigns reviews to clinical staff for quality of care inquiries requiring clinical review Works with the Clinical Quality Specialists Dental Consultants and other clinical staff to ensure that clinical issues are addressed.
- Preparing case files for external review of complaints including Independent Review Entity IRE.
- Identifying the root causes of complaints and works with the applicable operational departments to implement an appropriate resolution.
- Communicating resolutions to the complainant via telephone or written correspondence.
Office Manager
Ilcheon Joo DDS
Pine Grove, PA
07.2020 - 08.2022
- Manage day-to-day operations of dental office
- Open and close dental office according to office protocol
- Review the office for a neat, professional appearance and make necessary changes
- Check the daily schedule for accuracy and post it in all treatment rooms
- Answer and respond to telephone calls with professionalism
- Review supplies for reception and provide order to Dr.
- Ensure that HIPAA Notice of Privacy Practices Notice is on display
- Patient Management
- Maintain a professional reception area; organize patient education materials, etc.
- Greet and welcome patients and visitors to the practice
- Check in patients according to office protocol, verifying and updating patient information Manage recall and inactive patient system
- Oversee patient relations
- Help explain office policy to patients
- Confirm the next day's appointments according to protocol and patient preferences
- Schedule patients for efficient use of doctor and staff time
- Check patient quick-fill list to try to fill in cancellation and no-show appointment times
- Collect payment from patients at the time of treatment
- Make follow-up appointments as needed
- Prepare financial treatment plans and present plan options to patient at end of their appointment
- Assist in the treatment room as needed
- Records Management
- Gather and accurately record insurance information from patients
- See that records are stored securely and handled in compliance with HIPAA privacy and security regulations Accurately file patient information
- Arrange patient charts and radiographs for the next day's appointment
- Insurance
- Update insurance information on all patients at all times
- Submit treatment plans for predetermination of benefits
- Prepare claim forms for patients with dental insurance
- Assist in the resolution of problems with third-party payers
Office Manager
Peter J. Rattigan D.M.D., P.C.
Orwigsburg, PA
08.2001 - 03.2020
- Manage day-to-day operations of dental office
- Open and close dental office according to office protocol
- Review the office for a neat, professional appearance and make necessary changes
- Check the daily schedule for accuracy and post it in all treatment rooms
- Answer and respond to telephone calls with professionalism
- Review supplies for reception and provide order to Dr.
- Ensure that HIPAA Notice of Privacy Practices Notice is on display
- Patient Management
- Maintain a professional reception area; organize patient education materials, etc.
- Greet and welcome patients and visitors to the practice
- Check in patients according to office protocol, verifying and updating patient information Manage recall and inactive patient system
- Oversee patient relations
- Help explain office policy to patients
- Confirm the next day's appointments according to protocol and patient preferences
- Schedule patients for efficient use of doctor and staff time
- Check patient quick-fill list to try to fill in cancellation and no-show appointment times
- Collect payment from patients at the time of treatment
- Make follow-up appointments as needed
- Prepare financial treatment plans and present plan options to patient at end of their appointment
- Assist in the treatment room as needed
- Records Management
- Gather and accurately record insurance information from patients
- See that records are stored securely and handled in compliance with HIPAA privacy and security regulations Accurately file patient information
- Arrange patient charts and radiographs for the next day's appointments
- Track cases and referrals to and from other doctors
- Insurance
- Update insurance information on all patients at all times
- Submit treatment plans for predetermination of benefits
- Prepare claim forms for patients with dental insurance
- Assist in the resolution of problems with third-party payers
- Inventory Management
- Monitor inventory and order dental office supplies as needed
Education
No Degree - Social Sciences
Kutztown University of Pennsylvania
Kutztown, PACollege Prep - undefined
Pottsville High School
Pottsville, PA06.1996
Skills
Leadership skills
Team player
Communication and Interpersonal Skills
Analytical Skills
Dependability and a Strong Work Ethic
Maturity and a Professional Attitude
Adaptability and Flexibility
Good Personality
Multitasker
Office Management
Accounts Payable
Accounts Receivable
Dental Billing
Microsoft Outlook
Payroll
HIPAA
Medical Scheduling
Medical Office Experience
Records Management
Dental Coding
Accounting
Dental Office Experience
Human Resources
Customer service
Certification
Driver's License
Timeline
Quality Care Coordinator
Delta Dental
08.2022 - Current
Office Manager
Ilcheon Joo DDS
07.2020 - 08.2022
Office Manager
Peter J. Rattigan D.M.D., P.C.
08.2001 - 03.2020
College Prep - undefined
Pottsville High School
No Degree - Social Sciences
Kutztown University of Pennsylvania