Dental Insurance and Claim Specialist

- Developed expertise in understanding coverage specifics, including coinsurance, deductibles, individual maximums, frequencies, and limitations. Demonstrated proficiency in verifying insurance information through various dental insurance provider portals. Utilized direct phone communications with insurance representatives to confirm coverage details. Engaged in effective follow-up to resolve any discrepancies in insurance information.

Effectively managed denied claims by investigating the reasons and collaborating with insurance providers to rectify the issues resulting in significantly reduced denial rates.

Resolved billing discrepancies with attention to detail and ensured timely submission of dental claims.

- Effectively communicate with insurance provider representatives to resolve coverage issues, claims, and billing. - Communicated changes in insurance information and coverage effectively with the team and relevant personnel to ensure alignment and awareness.

I completed the process to submit and finalize Dental insurance claims for services rendered in 2022, which have been revised for submission. It resulted in the insurance providers paying most of the outstanding claims.

Meticulously verified patient insurance information and eligibility which facilitated smoother billing processes and reduced claims denials as a result.

Made outbound calls to patients to request additional information before their appointment to verify their insurance efficiently while ensuring compliance with HIPAA regulations.