Microsoft Office Suite (Word, Excel, Google Sheets)
Tausha Pelot
Success Consultant
Cuero,TX
Summary
Highly organized and detail-oriented professional with 15+ years of experience in customer service, insurance claims processing, and provider/patient relations. Expertise in claims management, dental billing, appeals, and reimbursement processes within both medical and dental insurance sectors. Skilled at navigating complex insurance protocols to resolve denials while ensuring compliance with HIPAA and OSHA regulations. Proven ability to build and maintain relationships with providers, patients, and insurance companies, delivering superior customer service and problem resolution. Seeking a customer service role within the insurance industry to leverage strong background in claims processing, research, and problem-solving.
Overview
26
26
years of professional experience
Work History
Success Consultant
eAssist Dental Solutions
Cuero, TX
03.2022 - Current
- Manage insurance claims processing for four dental offices nationwide, ensuring timely submission and resolution
- Investigate and resolve denied claims by filing appeals with appropriate documentation and following up with insurance carriers
- Accurately post insurance payments, reconcile discrepancies, and maintain up-to-date outstanding claims reports
- Provide detailed reports and insights on claim status and office performance to improve efficiency
- Collaborate with dental offices to verify patient insurance benefits, process preauthorizations, and ensure compliance with insurance policies and HIPAA standards.
Front Office/Insurance Coordinator, HIPAA/OSHA Compliance Officer, RDA
Victoria Family Dentistry
Victoria, TX
09.2012 - 05.2022
- Handled patient billing, insurance verification, and claims submission, ensuring correct coding and timely submission
- Managed claims denials and appeals, working directly with insurance companies to maximize reimbursement
- Coordinated patient appointments, treatment plans, and insurance coverage discussions with patients
- Ensured the dental office's compliance with HIPAA regulations and OSHA safety standards by conducting staff training and monitoring workplace safety
- Provided clinical chairside assistance to dentists during various dental procedures, including restorative treatments, root canals, and extractions.
Seafood & Perishable Food Buyer
Performance Food Group
Victoria, TX
02.2009 - 08.2012
- Developed strong relationships with suppliers, negotiated pricing, and ensured the availability of fresh and seasonal products
- Managed inventory levels, sourced products, and implemented purchasing strategies to meet operational needs while minimizing waste
- Collaborated across departments to align purchasing strategies with company goals and ensure timely product delivery.
Registered Dental Assistant
Rabel DDS, Inc.
Houston, TX
05.2006 - 02.2008
- Assisted dentists with various procedures, sterilized equipment, and maintained treatment room cleanliness to uphold high infection control standards
- Verified patient dental histories, took X-rays, and provided patient education on treatment plans and post-op care
- Scheduled appointments and managed patient files, ensuring seamless clinic operations and patient satisfaction.
Customer Service Representative
Performance Food Group
Victoria, TX
09.1998 - 08.2001
- Managed high volumes of inbound and outbound calls, processing food service orders for restaurants and coordinating delivery logistics
- Worked closely with the transportation department to arrange special deliveries, ensuring timely and accurate service
- Processed returns and refunds, addressing customer issues with damaged or out-of-date products
- Maintained high accuracy in order entry and ensured consistent communication with customers, making 50+ outbound calls daily.
Education
Some College (No Degree) - Dental Assisting
Wharton County Junior College
Wharton, TXSkills
- Proficient in Microsoft Office Suite (Excel, Word, Google Sheets)
- Customer Relationship Management (CRM) software expertise
- Proficient with dental practice management software (EagleSoft, Dentrix)
- Strong organizational and communication skills
- Attention to detail and active listening
- Excellent problem-solving abilities
- Patience and empathy in customer interactions
- Ability to work independently and meet deadlines
- Extensive knowledge of dental insurance processes, claims management, and appeals
- Familiar with HIPAA and OSHA compliance standards
- Clinical proficiency as a Registered Dental Assistant (RDA)
Educationcertifications
- Registered Dental Assistant (RDA) Certification
- Proficient in HIPAA and OSHA Compliance
References
References available upon request.
Timeline
Success Consultant
eAssist Dental Solutions
03.2022 - Current
Front Office/Insurance Coordinator, HIPAA/OSHA Compliance Officer, RDA
Victoria Family Dentistry
09.2012 - 05.2022
Seafood & Perishable Food Buyer
Performance Food Group
02.2009 - 08.2012
Registered Dental Assistant
Rabel DDS, Inc.
05.2006 - 02.2008
Customer Service Representative
Performance Food Group
09.1998 - 08.2001
Some College (No Degree) - Dental Assisting
Wharton County Junior College
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Work Preference
Work Type
Full TimeContract WorkWork Location
RemoteImportant To Me
Work-life balanceHealthcare benefitsWork from home optionPaid time offCareer advancementPersonal development programsCompany CultureSoftware
EagleSoft
Open Dental
Vyne Trellis
Remote Lite
CoPilot
AS400
Languages
English
Native language
Similar Profiles
Sabrina PaveySabrina Pavey
Dental Billing Specialist at EAssist Dental SolutionsDental Billing Specialist at EAssist Dental Solutions
Tausha PelotTausha Pelot
Success Consultant at EAssist Dental SolutionsSuccess Consultant at EAssist Dental Solutions
Riley AnglinRiley Anglin
Team Leader at Eassist Dental SolutionsTeam Leader at Eassist Dental Solutions