Tausha Pelot
Cuero,TX
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
Work History
Success Consultant
EAssist Dental Solutions
03.2022 - Current
- Currently work remote for 4 Dental offices in different parts of United States. Main responsibilities as Success Consultant:
- Submit clean and accurate claims either by electronic, mail, or enter on insurance web portal within 24 hours after office has batched claims
- Work outstanding claims aging report for each office, by researching and following up on all open claims over 30 days old every 14 days.
- Post insurance payments to patient ledgers, and entering accurate & easy to understand posting notes and adjustments.
- Appeal all claim denials that are appealable and follow-up on all outstanding appeals. Entering clear documentation on claim status and resolution.
- Submit daily reports for each office of all work completed that day.
- Work closely with dentist and office managers to ensure all necessary information is being entered into patient's charts by office staff, assistance, and hygienist.
- Respond to individual client support issues via phone, email and chat.
- Create and maintained help desk documentation to answer common support questions.
- Maintain confidentiality of patient finances, records, and health statuses.
- Handle customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Update account information to maintain customer records.
- Maintain customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Offer advice and assistance to customers, paying attention to special needs or wants.
- Adhere to strict HIPAA guidelines to protect patient privacy.
- Use data entry skills to accurately document and input statements.
- Respond to customer concerns and questions on daily basis.
- Generate monthly billing and posting reports for management review.
- Maintain accurate and up-to-date records of claim information for future reference.
Insurance Coordinator, HIPPA/OSHA Officer, RDA
Victoria Family Dentistry
09.2012 - 05.2022
- Filed insurance claims by obtaining and entering data related to patient, insurance provider and dental code for procedures and services provided
- Educated patients on treatment procedures and post-procedure home care
- Scheduled cleanings and dental appointments for patients using appointment software
- Checked patients in and out, verified insurance and collected co-pays to keep business administrative and financial records current
- Prepared new patient files and updated existing records with new personal, insurance and medical information
- Educated patients about post-operative and at-home care for optimal outcomes
- Supported dynamic patient flows by setting up and breaking down rooms, cleaning surfaces and restocking supplies
- Sanitized equipment, cleaned treatment rooms and restocked supplies after each patient's treatment to maintain cleanliness and prepare for next patient
- 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
- Took patient blood pressure, pulse and temperature and accurately recorded results in patient charts
- Reviewed patient records to check accuracy of information and implement updates
- Set up appointment times and handled canceled appointments
- Worked insurance aging report weekly any open claims over 30 days Documented file notes clearly and concisely Eaglesoft
- Managed all payments processing, invoicing and collections tasks
- Made daily bank deposit, responsible for balancing credit card, EFT, cash, insurance check or personal check payments
- Applied all insurance payments to patients account
- Monitored past due accounts and pursued collections on outstanding invoices
- Performed insurance verification, pre-certification and pre-authorization
- Submitted claims to insurance companies
- Produce quarterly and yearly reports detailing compliance findings and recommendations for improvements
- Trained new employees in proper safety procedures to minimize accidents with proper behaviors
- Recommended measures to help protect workers from potentially hazardous work methods, processes or materials
- Demonstrated leadership by making improvements to work processes and helping to train others
- Planned and executed compliance audits to check company policies, procedures and controls
- Maintained and revised policy procedures for general operation of compliance program
- Developed organizational methods and policies, implementing training initiatives to deliver ongoing awareness of and compliance with established procedures.
Performance
Seafood, Perishable, Food Group Co
05.2006 - 02.2008
- Worked closely with managers to plan special buys
- Researched competitors and sourced new vendors
- Documented purchasing activities, inventory reports and department records
- Negotiated favorable contracts and determined lowest possible cost, factoring in quality and reliability, by analyzing data
- Tracked and approved procurement plans and inventory levels
- Performed detailed reviewed of high and low-performing products
- Assessed trends and inventory usage to provide maximum product coverage for different time frames
- Collaborated with cross-functional teams to meet customer requirements and market demands
- Assisted managers in developing promotions to move existing stock
- Tracked shipments to ensure delivery on time and in excellent condition
- Negotiated with vendors and suppliers and administered contracts.
Registered Dental Assistant
Rabel DDS. Inc
05.2006 - 02.2008
- Sanitized equipment, cleaned treatment rooms and restocked supplies after each patient's treatment to maintain cleanliness and prepare for next patient
- Stocked and prepared exam and treatment rooms by setting up required instruments, tools, supplies and equipment
- Sterilized tools, exam chair, trays and surfaces for clean and safe dental office
- Escorted patients to exam rooms while making friendly conversation to prepare for cleanings and procedures
- Assisted dentists in permanent and temporary restorative procedures, applied dental fillings, placed temporary crowns and seated permanent crowns
- Gathered medical information, dental health history and vitals from patients
- Laid out dental instruments and equipment before procedures
- Educated patients on treatment procedures and post-procedure home care
- Scheduled cleanings and dental appointments for patients using appointment software
- Created bitewing, panoramic and periapical X-ray images for dentist to review
- Protected patients by sterilizing instruments and equipment between every consultation
- Passed instruments to dentist, gently sprayed water, suctioned fluids and mixed materials to support dentists during procedures
- Took preliminary impressions of patient teeth to prepare for custom impressions and fabrication of permanent dental work
- Supported dentist chairside with root canal and extraction procedures
- Positioned patients for treatment by making chair adjustments and prepared necessary equipment for procedures.
Supply and Equipment Buyer
US Foodservice
09.2001 - 05.2005
- Negotiated prices, discount terms and transportation arrangements with suppliers
- Examined, selected, and purchased merchandise consistent with specification requirements
- Negotiated pricing for apparel and accessories from vendors to secure optimal pricing and keep costs low
- Worked closely with team members to deliver project requirements, develop solutions and meet deadlines
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services
- Juggled multiple projects and tasks to ensure high quality and timely delivery.
Education
High School Diploma -
Magnolia High School
Magnolia, TX05.1996
Skills
- Critical Thinking
- Customer Service and Assistance
- Active Listening
- Investigation of Claims
- Resolving Customer Issues
- Insurance Terminology
- Dental Terminology
- Microsoft Office
- Claims Support
- Active Listening Skills
- Problem-Solving
- Organization and Time Management
Timeline
Success Consultant
EAssist Dental Solutions
03.2022 - Current
Insurance Coordinator, HIPPA/OSHA Officer, RDA
Victoria Family Dentistry
09.2012 - 05.2022
Performance
Seafood, Perishable, Food Group Co
05.2006 - 02.2008
Registered Dental Assistant
Rabel DDS. Inc
05.2006 - 02.2008
Supply and Equipment Buyer
US Foodservice
09.2001 - 05.2005
High School Diploma -
Magnolia High School
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