Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic
Melanie Y. Hernandez

Melanie Y. Hernandez

Irving,TX

Summary

Experienced professional coordinator with a background in both private and public sectors. Known for agility, tenacity, and meticulous attention to detail. Fluent in Spanish, adding a valuable asset to any team or project.

Overview

19
19
years of professional experience
1
1
Certification

Work History

Treatment Coordinator

Huckabee Dental
10.2023 - Current
  • Maintained detailed records of patient treatments, ensuring accurate billing and efficient followups.
  • Submitted claims along with proper documentation
  • Explained treatment choices to patients and helped determine best options.
  • Provided exceptional customer service to create a welcoming atmosphere for patients and their families.
  • Served as a liaison between patients, clinical staff, and external specialists during referral processes or collaborative care efforts.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Scheduled surgeries, managed pre-certifications and verified insurance coverage.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Complied with HIPAA guidelines and regulations for confidential patient data.
  • Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
  • Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
  • Achieved insurance pre-authorizations to enable timely patient procedures.
  • Reduced errors in billing by accurately maintaining patient records with updated insurance information.
  • Supported timely claims processing by submitting accurate and complete documentation to insurance companies.

Treatment and Insurance Coordinator

Arte Dental
01.2012 - 10.2023
  • Initiated plans for treatments, procedures, medications, and continuing care requirements. Contracted new providers with PPO insurance companies. Directed the training of permanent staff members and rotating volunteers to achieve the best performance. Used scheduling and reception management abilities to back up front-desk staff. Posted payments made by patients and insurance companies against medical liabilities. Submitted claims to insurance companies for payment. Collected payments from patients and reconciled daily cash reports. Scanned reports, patient consent forms, and chart forms into patient records.
  • Assisted patients in understanding their dental insurance benefits, coverage limits, and out-of-pocket expenses.
  • Supported patients throughout the treatment process by answering questions about their financial responsibility concerning deductibles, copayments, or coinsurance amounts.
  • Educated dental team members on insurance policies and procedures to promote a cohesive office environment focused on quality patient care.
  • Managed accounts receivable, decreasing outstanding balances through diligent follow-up with both patients and insurers.
  • Improved patient satisfaction by efficiently managing dental insurance claims and coordinating with providers.
  • Referenced monthly aging reports to follow up on unpaid claims and obtain maximum reimbursement.
  • Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.

Customer Service Representative

Careington International
01.2006 - 01.2008
  • Explained insurance benefits and breakdowns to providers. Gave overview of plans and policies to customers. Answered inbound calls in a call center. Processed insurance and discount plans.
  • Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
  • Responded to customer requests for products, services, and company information.
  • Handled sensitive customer information with discretion, adhering to strict data privacy regulations at all times.
  • Processed insurance policy cancellations and renewals quickly to meet call time targets.
  • Participated in ongoing training sessions to remain current on industry developments and improve overall job performance.
  • Reduced processing time for claims, aiding in quicker customer resolutions.
  • Managed high-volume call queues, ensuring minimal wait times for customer inquiries.
  • Processed and recorded new policies and claims.
  • Verified client information by analyzing existing evidence on file.

Education

Registered Dental Assistant License -

North Texas Dental Assistants
Plano, TX

High School Diploma - undefined

Frisco High School
01.2004

Skills

  • Dental Coding and Billing
  • Open Dental
  • Dentrix
  • Medical Imaging
  • HIPAA Compliance
  • Insurance coverage verification

Certification

Registered Dental Assistant

Languages

Spanish
Native or Bilingual

Timeline

Treatment Coordinator

Huckabee Dental
10.2023 - Current

Treatment and Insurance Coordinator

Arte Dental
01.2012 - 10.2023

Customer Service Representative

Careington International
01.2006 - 01.2008

High School Diploma - undefined

Frisco High School

Registered Dental Assistant License -

North Texas Dental Assistants

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