KIMBERLY MARTINEZ
Administrative Assistant
La Puente,CA
Summary
Enthusiastic professional eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Reliable employee successful at managing multiple priorities with a positive attitude. Skilled in working under pressure and adapting to new situations and challenge.
Overview
20
20
years of professional experience
Work History
Grievance and Appeals Coordinator
KAISER PERMANENTE
Rancho Cucamonga, CA
12.2020 - 10.2021
- Responded in writing to members and providers, advising on proper applications of dental benefits.
- Utilized strong judgment to identify appropriate handling by taking immediate action.
- Consistently maintained above average rate for timely. Acknowledgment and closure of grievance cases.
- Provided superior customer service to internal/external customers to ensure exceptional customer experience.
- Maintained composure in stressful situations and responded professionally.
- Answered daily phone calls from internal/external departments and public.
- Checked documentation for accuracy and validity on updated systems.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Maintained confidentiality of patient finances, records and health statuses.
- Calculated adjustments, premiums and refunds.
- Reviewed 50 patient cases per week and verified information.
Grievance and Appeals Coordinator
DELTA DENTAL
Cerritos, CA
01.2017 - 11.2020
- Composed 30-40 written letters weekly to providers, members, and regulatory entities.
- Managed large volumes of incoming calls and emails.
- Researched and reviewed customer concerns and grievances involving quality of service and benefit coverage.
- Coordinated with senior specialist to compose appeal responses.
- Ensured appropriate resolution to inquiries, grievances and appeals within specified timeframes.
- Verified client information by analyzing existing evidence on file.
- Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Maintained confidentiality of patient finances, records and health statuses.
Outside Sales Representative
SYSCO FOODS
Walnut, CA
10.2015 - 12.2016
- Maintained sales records, processed credits and prepared sales quotes.
- Reviewed and analyzed daily and weekly reports.
- Established new accounts through cold calling and personal visits to potential customers.
- Followed up with customers after completed sales to assess satisfaction and resolve technical or service concerns.
- Recorded accurate and efficient records in customer database.
- Visited customer locations to evaluate requirements, demonstrate product offerings and propose strategic solutions for diverse needs.
- Computed total costs and profit requirements for customer sales to provide accurate pricing.
- Collaborated with vendor representatives and company customers to set up optimal delivery schedules.
- Prospected continuously for new potential customers and maintained robust conversion rate.
- Attended monthly sales meetings and quarterly sales trainings.
- Negotiated prices, terms of sales and service agreements.
Insignia Designer/RDA
ORMCO
Glendora, CA
06.2013 - 10.2015
- Designed 20 orthodontic cases weekly utilizing Insignia software and prescription
- Evaluated case treatment plans from initial records to final design
- Educated office staff and doctors on software setup, design and marketing
- Assisted in new product testing
- Worked directly with Orthodontist chair side on clinical patients
- Worked closely with production to ensure timely delivery of cases to offices.
- Obtained approval of concepts by submitting rough drafts to management or to client.
- Identified design requirements for each project.
- Proved successful working within tight deadlines and fast-paced atmosphere.
Hygiene Coordinator/RDA
CALDWELL DENTAL
Cypress, CA
03.2011 - 01.2013
- Managed office schedules and calendars to coordinate administrative planning and execution.
- Coordinated meetings with General Dentist, Specialist and patients.
- Greeted new and existing patients.
- Performed general chair-side duties for general dentistry procedures and oral surgery.
- Scheduled appointments for new and existing customers, factoring in provider availability and scheduling loads.
- Assisted dentist with paperwork and billing protocol for both routine and less common procedures.
- Recorded patients' health histories, documented current symptoms and pulled up records from prior visits for dentists to view and evaluate.
- Scheduled appointments, prepared bills and received payment for dental services by completing insurance forms, verifying insurance information and maintaining records.
- Maintained dental supply inventory by checking stock to determine inventory levels and placing and expediting orders for supplies.
Orthodontic Supervisor/RDA/Auditor
SMILE CARE DENTISTRY
Santa Ana, CA
06.2009 - 03.2011
- Implemented marketing strategies to generate sales of orthodontic cases.
- Analyzed information to ensure that all offices adhere to all rules and regulations.
- Customer service support, evaluated and resolved issues and concerns.
- Verified proper operation of dental equipment by completing preventive maintenance, troubleshooting malfunctions and calling for repairs.
- Corresponded and followed-up with offices, regional directors and customers via email.
- Managed 5-10 staff members, ensuring compliance with regulatory guidelines.
- Audited and performed quality control procedures.
- Assisted in budget development by gathering, analyzing and reporting data.
- Monitored assigned budget lines and reported variances.
- Supported back office with x-rays, photos, impressions, assisted.
- Scheduled appointments, prepared bills and received payment for dental services by completing insurance forms, verifying insurance information and maintaining records.
RDA/Treatment Coordinator
STEPHEN TRACEY DDS
Upland, CA
06.1999 - 12.2007
- Effectively presented treatment plans and drafted quotes
- Performed chair-side orthodontic assistant techniques and procedures.
- Created financial arrangements and verified insurances.
- Responsible for inventory of office supplies and equipment.
- Provided general administrative support for office staff and Doctor.
- Responsible for emergency, health and safety compliance within office.
- Assisted with training Doctors and staff on new innovative products.
- Scheduled appointments, received and posted payments for patients.
- Public relations and marketing.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Prepared insurance claim forms, explained benefits and outlined pricing details for procedures and services.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Placed new supply orders, managed inventory and restocked clerical spaces.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Performed in team leader capacity and organized all treatment and placement activities
Education
Some College (No Degree) -
Chaffey Community College
Alta Loma, CASkills
Microsoft Word and Outlook
undefinedTimeline
Grievance and Appeals Coordinator
KAISER PERMANENTE
12.2020 - 10.2021
Grievance and Appeals Coordinator
DELTA DENTAL
01.2017 - 11.2020
Outside Sales Representative
SYSCO FOODS
10.2015 - 12.2016
Insignia Designer/RDA
ORMCO
06.2013 - 10.2015
Hygiene Coordinator/RDA
CALDWELL DENTAL
03.2011 - 01.2013
Orthodontic Supervisor/RDA/Auditor
SMILE CARE DENTISTRY
06.2009 - 03.2011
RDA/Treatment Coordinator
STEPHEN TRACEY DDS
06.1999 - 12.2007
Some College (No Degree) -
Chaffey Community College
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