Melissa Conde
Miramar,FL
Summary
Healthcare and Dental Insurance Specialist with 10+ years of experience in medical and dental insurance verification, billing, claims processing, and revenue cycle management both in office and remote. Exceptional leader who has an outstanding record of innovation, achievement of sustainable results, and is known for consistently exceeding expectations. A reliable professional who has diverse experience in member escalations and resolution, patient coordination, claim management, insurance breakdowns, treatment coordinating and prior authorizations.
Overview
6
6
years of professional experience
Work History
Member Care Advocate
Included Health (Remote)
11.2023 - Current
- First point-of-contact between patients, healthcare providers, medical clinical professionals, and insurance companies to address questions or concerns related to medical bills.
- Collaborate with leadership as subject matter expert for pod-level questions, assisting colleagues with complex processes, workflows, and issue resolution.
- Facilitate cross-functional pod training to enhance departmental goals, service levels, and performance expectations.
- Coordinate appeal processes, claims, denials and prior authorizations ensuring compliance with regulatory guidelines and organizational policies.
- New hire training specialist assisting colleagues with complex processes, workflow procedures, and issue resolution.
- Assist in implementing workflow updates and procedural changes, contributing to departmental training initiatives.
Assistant Manager
Sheridan Dental Center
Fort Lauderdale, Florida
08.2020 - 11.2023
- Assisting office manager with budget management and overall company contributions
- Collaborated with dentists to streamline treatment planning and case presentation processes.
- Developed and updated spreadsheets and databases to track, analyze and report on performance and sales data
- Employee scheduling and payroll assistance
- Created and finalized contracts for Dental and Orthodontic treatment and services treatment
- Processed insurance claims and verified coverage details for timely reimbursements
- Responsible for record management and quarterly analysis report
- Coordinated patient scheduling to optimize office flow and reduce wait times
- Oversaw patient records management, maintaining accuracy and compliance with regulationss
Education
Associate of Science - Medical Technology
Broward College
Fort Lauderdale, FL 08.2026 - 11.2026
Skills
- Bilingual: English and Spanish
- Insurance billing
- HIPAA compliance certified
- Peer Training and Mentorship
- Cross-Pod Training and Proficiency
- Quality Assurance specialist
- Insurance claims processing, grievances, appeals and prior authorizations
- CenPos/POS Payment Processing
- Dental software proficiency
- Inventory control
- Payment Processing and Payroll
- Performance reviews
- Risk management
- Sales, Scheduling, and Treatment Plan Coordination
Skills
- Bilingual: English and Spanish
- Insurance billing
- HIPAA compliance certified
- Peer Training and Mentorship
- Cross-Pod Training and Proficiency
- Quality Assurance specialist
- Insurance claims processing, grievances, appeals and prior authorizations
- CenPos/POS Payment Processing
- Dental software proficiency
- Inventory control
- Payment Processing and Payroll
- Performance reviews
- Risk management
- Sales, Scheduling, and Treatment Plan Coordination
Timeline
Associate of Science - Medical Technology
Broward College
08.2026 - 11.2026
Member Care Advocate
Included Health (Remote)
11.2023 - Current
Assistant Manager
Sheridan Dental Center
08.2020 - 11.2023