Senior Claims Associate
Extensive background in dental claims, managed within company standards and best practices complex and problematic dental claims within delegated limited authority to determine benefits due; worked closely with case managers.
Demonstrated success in negotiating win-win compromises, managed subrogation and negotiated settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim.
Skills
HIPPA trained
Proficient in Microsoft Office Suite
Dental Image Viewer
Privacy Overview Training
Proficient in Outlook
Typing- 40 wpm
Knowledge of dental terminology & clinical codes
Professional Experience
DC37 — from March 2001 until November 2010 - New York, NY
New York City’s Largest Public Union
Dental Claim Associate, Highly motivated Dental Claims Associate with more than nine years of diversified customer relations, training and team leader/supervisory experience.
Key Results:
Responded to member concerns and questions about the dental plans.
Worked on a dedicated team, which was designated to provide service to large groups.
Educated the member to have a better knowledge of their dental coverage.
Corrected claims and eligibility information in the system as necessary.
Processed and adjudicated dental claims for dedicated groups.
Consistently exceeded required quality standard of 125 claims per day.
Provided dental offices with complete breakdown of dental benefits, and faxed member eligibility as necessary.
New York Institute of Finance – from September 1997 u...
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