Summary
Overview
Work History
Education
Skills
Timeline
Generic

Melissa Wood

Auburndale,FL

Summary

Results-driven Insurance Coordinator offering 20-year proven success in maximizing reimbursement from wide range of insurance providers. Accomplished in improving accounts receivable and account management when providing exceptional service to patients. Eager to bring talent and expertise to a growing healthcare organization.

Overview

25
25
years of professional experience

Work History

Insurance Coordinator

Lake Myrtle Dental
03.2023 - Current
  • Posted and reconciled insurance payments and adjustments, as well as patient payments
  • Communicated with insurance companies, on a daily basis, regarding patient benefits and/or unpaid claims
  • Entered data using dental practice management software and generated reports for all activities
  • Uploaded completed insurance verification forms and breakdowns onto patient charts
  • Monitored weekly, monthly and quarterly reports, to confirm payment from insurance companies.
  • Prepared insurance claims for submission to clearinghouses or insurance companies.
  • Filed and tracked insurance claims and communicated claims status to patients.
  • Achieved revenue goals by managing collections and accounts receivables, referral process, and insurance billing.
  • 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.
  • Verified insurance and communicated coverage to staff and patients.
  • Obtained prior authorization and precertification for outpatient procedures.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Calculated adjustments, premiums and refunds.
  • Generated, posted and attached information to claim files.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Carried out administrative tasks by communicating with patients, distributing mail, and scanning documents.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Posted payments to accounts and maintained records.
  • Communicated effectively with staff members of operations, finance and clinical departments.

Treatment Plan Coordinator / Insurance Coordinator

Southwest Dental Group (formerly Finley & Runyan, LLP)
02.2020 - 11.2022
  • Scheduled appointments and maintained the appointment book
  • Created, documented, and presented detailed patient dental treatments plans and transactions, with an extensive success rate
  • Collected and processed payments from patients, and reconciled financial data
  • Prepared accurate and complete claim forms for dental insurance
  • Liaised with insurance companies regarding pending and overdue payments
  • Sent out billing statements and followed up on past-due balances
  • Extensive knowledge working with both Dentrix Ascend and Eaglesoft software
  • Insurance collections, payment posting, claims examining, tracing, appealed claims and audited accounts
  • Accounts receivable; entered in EOB's, posted insurance payments, and patient payments
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.

Insurance Sales & Support

LiveOps, Inc.
05.2010 - 01.2020
  • Resolved product or service problems by clarifying the customer's complaint/s, determining the cause of the problem, selecting and determining the best solution to solve the problem, and expediting correction or adjustment; following up to ensure resolution, maintained financial accounts by processing customer adjustments, and processed new insurance claims.
  • Tracked customer warranty claims and cost recovery amounts, resolved service issues and shared benefits of additional services, developed highly empathetic client relationships and earned a reputation for delivering exceptional customer service.

Office Manager

Dr. Linkston Cryer, DDS
01.2006 - 04.2010
  • Processed and reconciled payments, verified insurance benefits, scheduled appointments, collected co-payments, and scheduled appointments; reviewed accounts receivable and payable, and ordered office supplies.
  • Reviewed treatment plans, in detail, and costs associated with each procedure; coordinated with insurance companies regarding insurance claims and reimbursements and processed insurance claims.
  • Established and maintained patient recall in order to cultivate relationships and continuity of services; managed the daily "queue" of calls and patient appointments; demonstrated the ability to lead and motivate an outstanding dental care team.
  • Processed insurance claims, collected co-payments, posted insurance and patient payments; contacted insurance companies on outstanding dental claims; submitted pre-treatment estimates to insurance companies prior to patient treatment; reviewed patient treatment plans and organized financial arrangements with patients.
  • Handled patient billing issues, printed monthly patient statements, and A/R reports; scheduled, and confirmed office appointments; closed out at the end-of-day, printed daily reports, and daily bank deposits; ensured HIPAA compliance; performed monthly inventory, and maintained office receivables. Successfully managed entire front office.

Office Coordinator

Clemson Health Center
11.1999 - 12.2005
  • Prepared charts for patient appointments, answered incoming calls for all providers and coordinated the transfer of needed patient information with hospitals and doctor's offices.
  • Assisted patients in completing medical forms and collected fees, as per insurance protocol; responsible for assuring the readiness of the reception area, opening the building at the designated time, and having all front desk services fully operational at the start of business hours.
  • Collected all personal, medical, and insurance information in order to provide accurate verification of benefits, trained new employees on office procedures, policies, and protocols; provided administrative support for physicians in the practice, posted patient payments, as well as insurance payments.

Education

Associate of Science - General Studies

Troy University
Troy, AL
05-2009

Skills

  • Excellent administrative, planning and organizational skills, with solid knowledge of dental and medical terminology and procedures, with extensive knowledge of insurance filings Careful attention-to-detail, evident in accurate patient records and billing Ability to multi-task, prioritize, and manage time effectively Avid communication and interpersonal skills, strong phone contact handling and active listening skills with proven customer support experience
  • Insurance claims processing
  • Microsoft Office
  • Dental insurance experience
  • Medical terminology proficiency
  • Medical billing and coding
  • Medical billing proficiency
  • Customer service and assistance
  • Insurance processes
  • Accounts Receivable

Timeline

Insurance Coordinator

Lake Myrtle Dental
03.2023 - Current

Treatment Plan Coordinator / Insurance Coordinator

Southwest Dental Group (formerly Finley & Runyan, LLP)
02.2020 - 11.2022

Insurance Sales & Support

LiveOps, Inc.
05.2010 - 01.2020

Office Manager

Dr. Linkston Cryer, DDS
01.2006 - 04.2010

Office Coordinator

Clemson Health Center
11.1999 - 12.2005

Associate of Science - General Studies

Troy University

Similar Profiles

CREATE PROFILE
Melissa Wood