Summary
Overview
Work History
Education
Skills
Timeline
Generic

Theresa Perry-McNeil

Englewood,CO

Summary

Achieved significant advancements in claims processing, provider credentialing, re-credentialing at Espire Dental, and Northfield Dental Management's five practices, showcasing exceptional organizational skills and compliance knowledge. Excelled in teamwork and prioritizing work, enhancing operational efficiency, and contributing to a notable increase in revenue through strategic client negotiations and effective communication. A team player with a vast knowledge of dental terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail. Gifted in working with office managers, front desk staff, RCM, and others in need of claim information for their patients and supportive guidance to get claims processed and paid, along with credentialing new providers and re-credentialing providers that were in network at Espire Dental and Northfield Dental Management. Experience Claims Insurance Specialist/Credentialing Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering eight years of experience and willingness to take on any challenge.

Overview

9
9
years of professional experience

Work History

Insurance Claims Specialist

Espire Dental
01.2022 - 06.2024
  • Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
  • Verified patient information by analyzing existing evidence on file and submitted claim.
  • Generated, posted and attached information to claim files.
  • Determined proper course of action for the completion of claims processing with the insurance companies when needed.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Posted payments to accounts and maintained records.



Credentialing Specialist

Northfield Dental Managment, LLC (Five Practices)
01.2019 - 01.2021
  • Maintained each provider's files with all the essential information required by the government and payer applications.
  • Updated the CAQH database file for each provider as per the compliance by CMS.
  • Ensured the logins and other necessary information is accurate and maintained in the internal provider's grid.
  • Renewed the provider's license, such as DEA, Controlled Substance, or Professional, annually.
  • Added dental providers while completing the credentialing applications to the Medicare, Medicaid, and commercial payers.
  • For commercial payers, completed the re-credentialing applications.
  • Ensured that the revalidation requests issued by the government payers get completed.
  • Work with the billing staff and revenue cycle director to identify and resolve the denials. Complete the authorization issues related to the dental provider credentialing.
  • Take care of credentialing the new provider and re-credentialing the existing providers.
  • Update the provider's profile on NPPES, CAQH, PECOS, and CMS.

New Home Sales Associate

Berkeley Homes
02.2015 - 02.2019
  • Partnered with marketing team to develop promotional materials highlighting unique selling points of each property within inventory.
  • Organized and participated in open house events to showcase new homes, generating interest among potential buyers.
  • Collaborated with design team to present accurate floor plans and visual representations to potential buyers, enhancing their understanding of available options.
  • Developed and implemented marketing strategies to maximize sales and attract new clients.
  • Boosted customer satisfaction by providing in-depth information on new home features and customization options.
  • Managed contract negotiations professionally, securing favorable terms for both parties involved.
  • Worked closely with construction teams to ensure timely completion of projects according to client specifications while adhering to budget constraints.
  • Exceeded sales targets through effective communication and understanding of client needs, resulting in increased revenue for the company.

Education

Bachelor of Arts - Foriegn Language

Metropolitan State University of Denver
Denver, CO
05.2011

Skills

  • Teamwork and Collaboration
  • Organizing and Prioritizing Work
  • Information Verification
  • Communication
  • Computer-literacy
  • Detail-orientated
  • Claims processing until completion
  • Research
  • Knowledge of policies and credentials
  • Compliance

Timeline

Insurance Claims Specialist

Espire Dental
01.2022 - 06.2024

Credentialing Specialist

Northfield Dental Managment, LLC (Five Practices)
01.2019 - 01.2021

New Home Sales Associate

Berkeley Homes
02.2015 - 02.2019

Bachelor of Arts - Foriegn Language

Metropolitan State University of Denver
Theresa Perry-McNeil