Lesley Miles
Bassett,VA
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Motivated professional offering clinical knowledge in various aspects of dentistry and insurance . Adds value to any organization in need of great collaboration, interpersonal and multitasking abilities. Meets tight deadlines. Offers 10 years of management experience to achieve organizational goals. Communicative team leader with expertise in clinical review of dental claims and dental practice management. Committed to driving improvements in patient care through innovation and leadership.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Professional Review Clinical Specialist
Delta Dental of Virginia
Roanoke, VA
08.2021 - Current
- Reviewed and evaluated claims to determine if they meet criteria for DDVA reimbursement.
- Advised providers on information required for accurate reimbursement.
- Developed strategies to resolve complex issues related to denials.
- Examined claims, records and procedures to grant approval of claims.
- Retained strong dental terminology understanding in effort to better comprehend procedures.
- Checked in and out of country claims for documentation for appropriate coding, radiographs, charting, while catching errors and making revisions.
- Collaborated with fellow team members to manage large volume of claims.
- Processed claims for payment or forwarded to appropriate personnel/consultant for further investigation
- Collaborated with internal departments to troubleshoot problems relating to denials.
- Analyzed and interpreted policy language, dental records, and other relevant data to identify coverage issues.
- Recognized by management for providing exceptional work .
- Identified opportunities for automation of dental claims through the use of AI technologies.
- Maintained updated knowledge through continuing education and advanced training.
Practice Manager
Dr. Millard Radford DDS
Rocky Mount, VA
01.2013 - 08.2021
- Communicated with patients with compassion while keeping medical information private.
- Coordinated meetings with insurance companies regarding claims processing issues.
- Assisted in the recruitment, hiring, and training of new staff members.
- Conducted regular performance reviews for staff members to ensure quality standards were met.
- Coordinated execution and improvement of daily dental office practices.
- Developed and implemented new patient scheduling systems to improve efficiency.
- Routed laboratory or diagnostic results to appropriate staff.
- Responded to patient queries and concerns to resolve issues in accordance with company policies and procedures, healthcare regulations and dental board standards.
- Reviewed patient records for accuracy and completeness prior to treatment.
- Hired, trained and monitored new office employees and took corrective action when necessary.
- Implemented staff scheduling procedures to provide full coverage, supporting organizational needs.
- Developed marketing strategies to increase client base and revenue streams.
- Organized supply purchases, equipment upgrades and operating expenses.
- Performed bookkeeping duties, preparing and sending financial statements or bills.
- Maintained accurate financial records including budgets, invoices, payments received and made.
- Tracked expenses associated with running a successful dental practice.
- Completed relevant insurance and other claim forms.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
- Managed daily operations such as billing, accounts receivable and payable, payroll, and employee relations.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Monitored inventory levels of necessary supplies and equipment for the dental office.
- Scheduled patient appointments and effectively handled cancellations and last-minute adjustments.
- Ensured compliance with all applicable laws, regulations, policies, procedures, and standards related to dental practice management.
- Maintained updated knowledge through continuing education and advanced training.
Certified Dental Assistant
Dr. Millard Radford DDS
Rocky Mount, VA
01.2011 - 08.2013
- Facilitated communication between dentist, hygienist, patient to ensure smooth flow of procedure.
- Conducted preliminary interviews of new patients to obtain medical histories and completed forms accordingly.
- Sterilized tools, exam chair, trays and surfaces for clean and safe dental office.
- Applied protective coating of fluoride to teeth during dental procedures.
- Documented patient records during procedures and added notes taken to treatment chart.
- Fabricated custom teeth impressions and temporary restorations for patients from given samples.
- Exposed dental diagnostic x-rays.
- Assisted in laboratory work such as pouring models, trimming dies, making temporaries.
- Stocked and prepared exam and treatment rooms by setting up required instruments, tools, supplies and equipment.
- Prepared materials for restorations, taking impressions, and fabricating temporary crowns.
- Created dental x-rays using traditional and digital methods to help dentists detect tooth decay, cavities and other issues needing to be treated.
- Supported dentist with completing minimally invasive and advanced surgical procedures.
- Created and fit dental appliances for patients. adjusting as necessary.
- Protected patients by sterilizing instruments and equipment between every consultation.
- Assisted with the placement of sealants, topical anesthetics, and fluoride treatments.
- Maintained patient records accurately in accordance with HIPAA regulations.
- Built loyal patient following and retained return patients by providing empathetic and caring service.
- Set up trays for specific dental procedures according to established protocols.
- Educated patients on treatment procedures and post-procedure home care.
- Assisted dentists in permanent and temporary restorative procedures, applied dental fillings, placed temporary crowns and seated permanent crowns.
- Explained dental services and payment plans to help patients make informed decisions.
- Took patient blood pressure, pulse and temperature and accurately recorded results in patient charts.
- Ordered dental supplies to maintain adequate inventory levels.
- Educated patients on proper oral hygiene techniques and postoperative instructions.
- Took bitewing, periapical, panoramic and occlusal X-rays and prepared for dentists to review.
- Entered patient data into dental records system and observed confidentiality rules to maintain patient privacy.
- Produced opposing models, study casts and impressions to provide dentists with information on relationship between teeth, gums and dental arches.
- Ensured that all safety policies were adhered to while performing clinical duties.
Certified Dental Assistant
J. Peyton Moore DDS
Martinsville, VA
01.2004 - 08.2009
- Educated patients on techniques to optimize oral hygiene, control plaque and protect teeth and gums.
- Explained dental services and payment plans to help patients make informed decisions.
- Fabricated custom teeth impressions and temporary restorations for patients from given samples.
- Sterilized instruments according to established guidelines and protocols.
- Responded promptly to requests from other staff members or dentists while maintaining a professional demeanor.
- Documented patient records with procedures performed and added notes taken to charts.
- Ordered supplies necessary for daily operations of the practice.
- Took digital X-rays of teeth using radiographic equipment.
- Prepared dental materials such as amalgam, composite resin, impression material and cements for use by the dentist.
- Provided support services such as stocking rooms with supplies, cleaning trays and changing linens between patients.
- Entered patient data into dental records system and observed confidentiality rules to maintain patient privacy.
- Assisted in laboratory procedures such as mixing impression materials or pouring casts from impressions taken by dentists.
- Fabricated temporary crowns or bridges from impressions taken by the dentist.
- Took bitewing, periapical, panoramic and occlusal X-rays and prepared for dentists to review.
- Built loyal patient following and retained return patients by providing empathetic and caring service.
- Took preliminary impressions of patient teeth to prepare for custom impressions and fabrication of permanent dental work.
Education
Health Sciences
Virginia Western Community College
Roanoke, VA08-2011
Skills
- Clinical Assessment Management
- Dental Terminology
- Decision-Making
- Critical Thinking
- Attention to Detail
- Documentation and Reporting
- HealthEdge Software
- Technical Troubleshooting
- Medical Records Review
- Quality Assurance
- Precise
Certification
- CDA - DANB 2008
- Dental Radiograph Certification - 2004
- Healthcare Provider CPR/BLS- Current
- Six Sigma - 2021
Accomplishments
- Core Values Leader DDVA 2023
- Respect Certification DDVA 2022
- Learn Certification DDVA 2022
References
References available upon request.
Timeline
Professional Review Clinical Specialist
Delta Dental of Virginia
08.2021 - Current
Practice Manager
Dr. Millard Radford DDS
01.2013 - 08.2021
Certified Dental Assistant
Dr. Millard Radford DDS
01.2011 - 08.2013
Certified Dental Assistant
J. Peyton Moore DDS
01.2004 - 08.2009
Health Sciences
Virginia Western Community College
- CDA - DANB 2008
- Dental Radiograph Certification - 2004
- Healthcare Provider CPR/BLS- Current
- Six Sigma - 2021
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