Insurance Verification & Eligibility
-Accessed multiple payer web portals daily to retrieve and verify comprehensive patient insurance details, including real-time eligibility and complex plan exclusions.
-Verified specific frequency limitations, tooth history, annual maximums, and deductibles to ensure 100% accuracy in patient financial estimates.
-Cross-referenced scanned insurance cards against system data to identify discrepancies, ensuring data integrity before clinical procedures began.
-Performed proactive outbound inquiries to insurance carriers to secure "hidden" details, such as waiting periods and missing tooth clauses, reducing surprise out-of-pocket costs.
-Updated patient accounts with the most current information and documented all verification actions to provide a clear audit trail for the billing department.
Claims, Posting & Revenue Cycle Management
-Submitted all daily dental claims with necessary electronic attachments (NEA/FastAttach), achieving a high first-pass clean claim rate.
-Posted insurance payments (ERAs/EFTs) and manual checks with meticulous attention to detail, reconciling patient ledgers to maintain an error-free financial record.
-Aggressively pursued aged claims and outstanding A/R (30/60/90+ days), successfully recovering lost revenue and reducing the overall collection cycle.
-Analyzed EOBs to identify and appeal wrongful denials, negotiating directly with insurance adjusters to secure maximum reimbursement for the practice.
-Executed End of Day (EOD) reporting.
Operated independently with zero to minimal supervision, adapting quickly to office SOPs.
