Summary
Overview
Work History
Education
Skills
Timeline
Generic

Serena Patton

Irving

Summary

Demonstrative Claims Auditor with background reviewing payment processes to deliver services, correct pricing and timely payments. Highly collaborative individual with over 5 years providing exceptional service via email and telephone to various individuals and organizations. Offering experience in different software applications and accounting procedures.

Overview

4
4
years of professional experience

Work History

Credentialing Claims Auditor

Mb2dental
06.2024 - Current
  • Analyzed rejected claims to identify root causes and implemented effective resolutions to reduce denial rates.


  • Audited dental claims for accuracy, validity, and adherence to provider credentialing and network participation requirements.
  • Ensured claims were submitted and paid only for properly credentialed, licensed, and contracted providers.
  • Reviewed provider credentialing files and enrollment data in coordination with the credentialing team to confirm licensure, certifications, NPI numbers, and payer participation.
  • Educated internal teams and dental provider offices on credentialing compliance, documentation standards, and billing best practices to reduce processing errors.


Insurance Verification Specialist

Mint Dentistry
08.2023 - 06.2024
  • Assisted in training new employees on the best practice for efficient insurance verification process and procedures.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Manages high volume insurance verifications within pressured timeframes.
  • Utilized various software programs to verify different Insurance carriers.
  • Contributed to company’s bottom line by reducing write-offs due to incorrect or outdated insurance information.
  • Ensured compliance with HIPPA regulations while managing sensitive patient information during the verification process.

Medical Billing and Collections Specialist

Lovett Dental
10.2022 - 06.2023
  • Assisted in reconciling deposits and patient collections
  • Entered invoices requiring payment and disbursed amounts via check, EFT or bank draft
  • Processed online and paper appeal submission and refund request
  • Utilized various software programs to process payments
  • Corrected, completed, and processed claims for multiple payer codes
  • Audited and corrected billing and posting documents for accuracy
  • Used data entry skills to accurately document and input statements

Administrative Assistant

Modivcare
07.2021 - 01.2022

Education

Medical Billing & Coding -

Altius Career College
Bissonnet, TX
09.2022

GED - undefined

TX Education Agency
Houston, TX
03.2020

Skills

  • Electronic Medical Records
  • Posting Ledgers
  • Claims Entry / Submission
  • ICD-10/ CPT/ HCPCS Coding
  • Scheduling Appointments
  • Data Entry
  • CMS 1500
  • Proficient in credentialing and provider enrollment systems, including CAQH, Cred Stream, and payer portals
  • Skilled in dental claims and practice management platforms such as Dentrix, Eaglesoft, and Epic Dental
  • Verification of Insurance
  • Aging Reports
  • HIPAA / OSHA /CPR Certified
  • Claims analysis

Timeline

Credentialing Claims Auditor

Mb2dental
06.2024 - Current

Insurance Verification Specialist

Mint Dentistry
08.2023 - 06.2024

Medical Billing and Collections Specialist

Lovett Dental
10.2022 - 06.2023

Administrative Assistant

Modivcare
07.2021 - 01.2022

GED - undefined

TX Education Agency

Medical Billing & Coding -

Altius Career College

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