Lavada Daniels
Chicago,IL
Summary
Dynamic Billing Specialist with extensive experience at Elite Dental Partners, adept at insurance claim processing and billing reconciliation. Proven ability to enhance team collaboration and streamline billing operations, ensuring accuracy and compliance. Skilled in Dentrix and Microsoft Office, with a strong focus on problem-solving and attention to detail.
Overview
19
19
years of professional experience
Work History
Billing Specialist
Elite Dental Partners
Chicago, IL
05.2021 - Current
- Processed claims, updated patient files, reviewed provider narratives, and verified dental codes, notes, ortho, and implant claims while following denial call procedures and A/R report requirements.
- Processed all claims in Dentrix Ascend.
- Managed patient claims for multi-location dental practices and specialist offices.
- Checked insurance eligibility and benefits through practice management systems.
- Posted payments and adjustments within dental billing records.
- Prepared billing reports for internal review and compliance tracking.
- Responded to customer questions about billing, payments, and account status.
- Collaborated with team members to identify and improve billing processes.
- Reviewed incorrect billing and processed refunds as needed.
- Resolved differences between customer remittances and invoices received.
- Supported other departments within organization as needed.
- Calculated billing charges and prepared claims for submission to insurance companies.
- Entered data into accounting software such as QuickBooks.
- Completed additional duties assigned by management team.
Dental Billing Specialist
Kore Sae, LLC/Contract Cook County Hospital
Chicago, IL
10.2018 - 05.2021
- Answered calls for MCO, Medicaid, Medicare, and commercial plans.
- Performed data entry into the practice management software system accurately and efficiently.
- Coordinated with other departments regarding billing information or questions from patients or third-party payers.
- Reviewed medical and dental billing, checked provider notes, and matched narratives with dental codes before claim submission.
- Submitted claims, followed up on denied insurance claims, and contacted insurance companies for resolution.
- Posted payments in Dentrix systems.
- Reviewed verification steps to spot and reduce fraudulent submissions.
- Checked health and dental insurance details, confirmed enrollment eligibility, handled correspondence, answered account questions, and posted Medicaid and insurance payments to patient accounts using different software programs. Processed medical and dental claims through Dentrix.
Dental Insurance Biller
Dental One
Schaumburg, IL
11.2014 - 09.2018
- Processed medical and dental billing after service completion.
- Worked with Dental One staff to resolve claim questions and billing issues.
- Followed HIPAA rules while handling confidential patient information.
- Contacted insurance companies by phone and email for claim status updates.
- Prepared, submitted, and tracked reimbursement claims with insurance carriers.
- Used plan portals to verify and explain patient eligibility, including coordination of benefits and Medicare replacement or supplemental coverage.
- Updated patient eligibility details in Epic.
- Reviewed unclear, missing, or conflicting codes and diagnoses, then asked doctors or clinic managers for clarification.
- Submitted medical and dental claims with required documentation.
- Partnered with internal teams and payers to process client funding and confirm funding detail accuracy.
- Followed up with insurance carriers on unpaid or rejected claims and resubmitted claims when needed for available assistance.
- Used Microsoft Office to prepare client correspondence, spreadsheets, filing systems, records, bills, invoices, and payment postings while following established guidelines and procedures.
Patient Account Representative
Houston Methodist Hospital
Houston, TX
02.2008 - 06.2013
- Educated patients on medical rights and care options during and after facility stay.
- Identified insurance payer sources and verified coverage details.
- Reviewed patient financial needs and referred cases to appropriate federal, state, or county assistance agencies.
- Resolved issues affecting care progression by improving information flow and addressing problems.
- Collected copayments to meet patient financial obligations, including applicable deductibles.
- Answered telephone promptly and politely, providing information and assistance.
- Stayed current on community services and program resources useful for patient needs.
Education
Some College (No Degree) - Medical Coding
Truman College
Chicago, ILSkills
- Adaptable and flexible to change
- Team collaboration
- Data entry proficiency
- Critical thinking
- Problem solving
- Attention to detail
- Effective communication
- Medicare billing
- Billing reconciliation
- Insurance claim processing
- Insurance confirmation
- Billing systems and software
- Client relationship management
- Monthly billing management
- Claims processing
- Multitasking and organization
- Customer service
- Decision-making
- Problem-solving
- Cash posting
- Financial forecasting
- Microsoft office
- Review documents
- Strong communication skills
- Interpersonal collaboration
- Computer literacy
- Medical billing and coding
- Insurance verification
- ICD-10 and ICD-9 proficiency
- Medical records management
- Medical scheduling expertise
- Experience in medical office operations
- Patient care knowledge
- Medical terminology expertise
- Clerical support experience
- HIPAA compliance
- Injection administration skills
- Physiology understanding
- Cerner software proficiency
- Benefits administration knowledge
- 10-key data entry
- Microsoft Office suite proficiency
- Management skills
- Documentation review and analysis
- Adobe Acrobat proficiency
- Microsoft Word expertise
- Excel spreadsheet skills
Relocation Preference
Anywhere
Work Authorization - Status
Authorized to work in the US for any employer
Personal Information
Willing To Relocate: 1
Timeline
Billing Specialist
Elite Dental Partners
05.2021 - Current
Dental Billing Specialist
Kore Sae, LLC/Contract Cook County Hospital
10.2018 - 05.2021
Dental Insurance Biller
Dental One
11.2014 - 09.2018
Patient Account Representative
Houston Methodist Hospital
02.2008 - 06.2013
Some College (No Degree) - Medical Coding
Truman College