Kiara Rizo
Summary
An energetic and fast learner motivated to acquire career advancement within a surgical environment in which I can utilize my exceptional customer service and dental assisting skills. A dedicated individual driven to make meaningful contributions to the growth of an industry while expanding my expertise.
Overview
11
11
years of professional experience
Work History
SURGICAL REPRESENTATIVE
Rutgers Health University Dental Associates
09.2024 - Current
- Developed and implemented new protocols and procedures for efficient workflow and improved surgical outcome as well as patient care.
- Schedule outpatient/ inpatient surgical procedures through various electronic medical record systems such as Epic and IQUEUE. Sometimes requesting "special request" outside of block time.
- Request prior authorizations/pre-certifications through web-based insurance systems and over the phone
- Coordinate surgical schedules for physicians to ensure appropriate use of block time and maximize productivity.
- Confirm surgical cases are booked appropriately and any required authorization, payment and/or signed document is correct and obtained beforehand.
- Ensure all authorizations are documented in relevant systems and that all information entered complies with patients’ insurances.
- Maintain surgical procedure and imaging authorization spreadsheet.
- Request authorization for imagings, such as MRI, CTA, CT scans, etc.
- Investigate coverage for uninsured, motor vehicle accident, and work comp cases/patients.
- Verify patient eligibility and benefits.
- Obtain required authorization, using HCPCS Codes, for nutritional supplements and medications.
- Effectively communicate with front desk, utilization management, nurses and medical director to give all pertinent clinical documentation as required to secure the surgical authorization.
- Schedule, as needed, peer-to-peer with providers and medical director / specialty reviewers.
- Track status of pending pre-certifications and pre-authorizations. Manage any changes in surgical dates.
- Maintain and update notes on the Authorization Status Report for all team members to access information, as needed.
- Input CPT/ CDT codes in the system, in preparation for billing
- Gather medical clearances, H&Ps and any other relevant information prior to surgery to submit to the hospital
- Inform patients of insurance coverage and financial responsibilities
- Collaborate with Co-surgeon's specialist to ensure multiple surgical procedures are effectively coordinated and authorized.
- Submit appeals to overturn authorization denials.
- Responsible for maintaining excellent communication and serve as liaison between patients and other entities.
- Send referral information to other specialist such as oncology, radiation, reconstruction, physical therapy, etc. in preparation for surgery or post surgical procedures.
- Submit authorization/pre-certification for orthodontic treatment
CLINICAL SERVICE REPRESENTATIVE I
Rutgers Health University Dental Associates
01.2022 - Current
- Process Insurance payments accurately, including electronic funds transfers/checks/POS
- Responsible for monitoring and collecting all patient outstanding balances
- Inform patients on pre-treatment estimates and their financial responsibility, according to submitted insurance predeterminations for planned treatments
- Liaison between providers and patients on insurance guidelines and status of authorizations for treatment
- Data entry for insurance pre-determinations and pre-authorizations
- Daily reconciliation reports
- Collect and process patient co-pays
- Monitor provider scheduling
- Re-bill patient accounts and allocate payments accordingly
- Insurance Verification
- Provide requesting records to patients, other facilities and attorneys
- Establish payment plan agreements for all accepted treatment for all practice specialties
- Provided customer service and answered queries over the phone
- Created various spreadsheets and implemented organizational procedures
- Work alongside other departments to make/ implement changes to the practice benefit
- Register new patients and update necessary information for existing patients to maintain current record
- Provide support to staff nurse by attending to pre and post op inquiries for surgery patients and documenting communication, as requested by the provider
- Create payment plans for orthodontic treatment
DENTAL ASSISTANT
Rutgers Health University Dental Associates
07.2019 - 01.2022
- Assisted with procedures for a variety of specialties and providers
- Explained procedures and treatment to patients
- Reviewed health history forms and verified medical clearance prior to surgery
- Responsible for pre and post operative phone calls and transferred any concerns/issues to the appropriate personnel
- Maintained efficient oral surgery logs
- Provided end of month statistics report for sedation and oral surgery procedures to the head of the Oral Surgery department
- Shipped all lab cases and properly recorded all tracking information into the appropriate chart
- Monitored the accurate delivery of specimens to the proper lab
- Managed proper inventory surplus and purchasing
- Collaborated with a surgical coordinator to send pre-authorizations and pre-determinations for upcoming in-office and hospital procedures
- Registered patients and verified insurance eligibility
- Greeted patients and answered any inquiries
- Provided extensive administrative support
FRONT DESK RECEPTIONIST / DENTAL ASSISTANT
Dental Plus Dental Center
01.2018 - 07.2019
- Data entry, filing and processing routine paperwork
- Managed high volume calls with tact and professionalism
- Ordered and distributed office supplies accordingly
- Received payments and accurately entered them into the patient’s account
- Responsible for adequately distributing all mail received
- Located and advised patient’s of delinquent accounts by telephone/ notices by mail
- Maintained all adequate demographic and insurance information for all patients
- Created new patient, recall and restorative appointments daily
- Verified insurance eligibility
FRONT DESK RECEPTIONIST / DENTAL ASSISTANT
Perth Amboy Pediatric Dentistry & Orthodontics
03.2015 - 12.2017
- Verified patient’s insurance information for eligibility purposes and to provide accurate estimates of treatment cost.
- Answered inquiries about dental coverage and claims and collect patient co-payments
- Maintained all adequate demographic/ insurance information for all patients
- Acted as a primary liaison between patients and insurance companies
- Coordinated and scheduled outside office events such as visiting local schools for marketing purposes.
- Advertised for the practice at various locations including Greater New York Dental Meeting.
- Accurately submitted dental claims to insurance companies in order to comply with timely filing guidelines.
- Diligently prepared and submitted monthly and yearly reporting.
- Managed, documented and efficiently resolved customer service issues.
Education
Associate of Business Administration -
Middlesex County College
Edison, NJCertified Billing & Coding Specialist - Medical Billing & Coding
American Institute of Medical Sciences
Edison, NJ04.2024
Certified Dental Assistant With Radiology License -
ACI Medical & Dental School
Eatontown, NJ08.2017
Skills
- Microsoft Office: Word, Powerpoint, Excel
- Adobe Acrobat
- DANB Radiation Health & Safety & Infection Control Certification
- American Heart Association - Healthcare Provider, AED/CPR Certified
- Bilingual: Able to fluently read, write and speak Spanish
- Comfortable with multiple systems & software's such as Epic, Axium, etc
Timeline
SURGICAL REPRESENTATIVE
Rutgers Health University Dental Associates
09.2024 - Current
CLINICAL SERVICE REPRESENTATIVE I
Rutgers Health University Dental Associates
01.2022 - Current
DENTAL ASSISTANT
Rutgers Health University Dental Associates
07.2019 - 01.2022
FRONT DESK RECEPTIONIST / DENTAL ASSISTANT
Dental Plus Dental Center
01.2018 - 07.2019
FRONT DESK RECEPTIONIST / DENTAL ASSISTANT
Perth Amboy Pediatric Dentistry & Orthodontics
03.2015 - 12.2017
Associate of Business Administration -
Middlesex County College
Certified Billing & Coding Specialist - Medical Billing & Coding
American Institute of Medical Sciences
Certified Dental Assistant With Radiology License -
ACI Medical & Dental School
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