ulanda mosley
Jacksonville,FL
Summary
Detail-oriented and customer-focused professional with over 9 years experience in healthcare and dental office settings, specializing in customer service, patient support, and claims coordination . Proven ability to manage high-volume interactions, verify insurance, process claims, and resolve issues efficiently while maintaining accuracy and confidentiality. Strong communication and organizational skills with a commitment to delivering excellent service and improving overall client and patient satisfaction.
Overview
16
16
years of professional experience
Work History
Patient Care Coordinator
Larroc Dental
Jacksonville, FL
08.2022 - 10.2025
- Patient registration
- Treatment planning
- Billing and coding
- Insurance verification
- Account management
- Insurance claim and adjustments
Claims Representative
Cigna
Jacksonville, FL
06.2020 - 11.2024
- Review claims accuracy and completeness
- Evaluate claims against insurance policies, medical necessity guidelines, and regulatory requirements
- Approve, deny, or request additional information for submitted claims
- Ensure compliance with HIPAA, state, and federal regulations
- Analyze clinical documentation to validate services billed
- Investigate and resolve claim discrepancies.
- Communicate with healthcare providers regarding claim status, corrections, or missing information
- Process adjustments, appeals, and reconsiderations for denied claims
- Maintain detailed and accurate records of claim decisions and actions taken
- Meet productivity, quality, and turnaround time standards
- Validates claims submission details against systems data.
- Knowledge in medical, institutional, and behavioral health claims processes
Patient Care Coordinator/Office Manager
Great Expressions Dental Centers
Jacksonville, FL
11.2016 - 01.2021
- Manage daily operations of the dental office, ensuring smooth front-desk and back-office workflow
- Supervise, train, and schedule administrative and clinical support staff
- Oversee patient scheduling, intake, and follow-up to maximize office efficiency
- Handle insurance verification, claims submission, billing, and payment processing
- Maintain accurate patient records in compliance with HIPAA regulations
- Monitor office finances, including payroll, budgeting, and accounts receivable
- Address patient concerns and ensure high levels of patient satisfaction
- Coordinate with vendors, dental labs, and suppliers; manage inventory and ordering
- Ensure compliance with OSHA, HIPAA, and state dental regulations
- Support dentists with reporting, performance metrics, and operational improvements
Claims Representative
Formativ Health
Jacksonville, FL
11.2017 - 02.2019
- Review and process health insurance claims for accuracy and completeness
- Verify patient information, coverage eligibility, and benefits
- Analyze medical codes (ICD, CPT, HCPCS) and ensure proper billing practices
- Approve, deny, or adjust claims based on policy guidelines
- Investigate and resolve claim discrepancies or denials
- Communicate with healthcare providers, members, and insurance companies regarding claim status
- Maintain detailed and accurate records of all claim activities
- Ensure compliance with federal and state healthcare regulations (such as HIPAA)
- Meet productivity and quality standards set by the organization
Member Service Representative II
Bank of America
Jacksonville, FL
03.2010 - 07.2015
- Provide personalized financial services to clients, including advice on banking products, loans, mortgages, and investment options.
- Assist clients in managing accounts, ensuring proper documentation, and addressing customer inquiries in a timely and professional manner.
- Process financial transactions, such as deposits, withdrawals, and wire transfers, while adhering to bank policies and regulatory requirements.
- Evaluate credit applications and assess financial data to determine loan eligibility and risk levels.
- Develop and maintain strong
- Relationships with clients, fostering trust and promoting bank services to meet financial goals.
- Identify cross-selling opportunities and achieve sales targets for products such as savings accounts, credit cards, and insurance.
- Maintain up-to-date knowledge of industry regulations, compliance standards, and bank products to ensure accurate and effective service delivery.
- Resolve customer complaints and concerns efficiently, aiming to enhance customer satisfaction and
Education
Associate's degree - undefined
high school diploma - undefined
Skills
Clinical documentation
EHR systems
Data entry
Customer Service
Insurance verification
HIPAA
Documentation
Attention to detail
Excel
Microsoft systems
Timeline
Patient Care Coordinator
Larroc Dental
08.2022 - 10.2025
Claims Representative
Cigna
06.2020 - 11.2024
Claims Representative
Formativ Health
11.2017 - 02.2019
Patient Care Coordinator/Office Manager
Great Expressions Dental Centers
11.2016 - 01.2021
Member Service Representative II
Bank of America
03.2010 - 07.2015