Specialty Benefits Coordinator

Vanessa I Pineda
6484 Gloria Dr
Sacramento, CA 95831

▪Fluent in Spanish ▪Dental office & dental insurance experience ▪Answer multiple phone lines ▪Self-motivated ▪Experience working with General and Specialist Dentists▪Excellent customer service and interpersonal skills ▪Experience working in high pressure environment ▪ Organizational skills

Pacific Dental Services. Specialty Benefits C oordinator 10/10 to Present
• I am a Specialty Benefits Coordinator and have spent 8 years growing in front office knowledge. I am extremely versed in insurance coordinating in both general and specialty dentistry. Have experience coordinating specialist schedules as well as working with general dentists daily. Have gross knowledge of maximizing insurance reimbursements as well as estimating patient co-pays. Address the need of patients and clinicians including (Endodontist,Periodontist,and Oral Surgeon) in a fast-paced culture. Educate patients on payment options. Secure patients financial commitment to help them start the best treatment possible. Keep accurate financial records using patient software programs. Answer multiple phone calls. Efficiently perform insurance verification and pre-authorization functions. Collecting payments and posting charges, payments and adjustments. Performs necessary duties associated with checking patients in and out. Record treatment information in the patients chart. Schedule and register New Patients and insure all required documentation is completed by patient. Insuring proper consent forms are signed. Schedule patients for exams and surgery. Answer questions and provide prior pre-operative instructions to patients prior surgery appointment and post-operative information to families. Charge out and audit end of the day production for all providers.

Alpha Dental. Office Manager​​​​​​​ 4/06 to 7/06
• Provided excellent customer service for English and Spanish patients. Responsible for staff Payroll. Managed patient appointments. Accounts receivable for patient accounts posting PPO, HMO, and Healthy Families payments. Traced all PPO's and Healthy Families Insurance claims for status of payment. Investigated patient benefit’s through insurance companies. Coordinated receiving and stocking of supplies. Charted patients treatment for the doctors.

Pacific Dental Services. Treatment Coordinator. ​​​​5/05 to 3/06
• Responsible for sending and calling in referrals for HMO insurances. Coordinated treatment for doctors. Accounts receivable for patients with past due accounts. Financial evaluation of patient’s credit score. Constantly review status of waiting room on a routine basis to ensure that patients were being seen in a timely fashion. Patient follow up and scheduling future appointments. Confirming appointments and aiding in productive daily schedules. Aid in referring patients out for specialty services as needed. Explained and communicated best standard of treatment according to doctor’s diagnoses. Coordinated dental benefits and arranged payment plans with patients.

Western Dental Services. Insurance/Denti-Cal Biller​​​​2/02 to 5/05
• Processed Treatment Authorization Request (TAR) for Denti-Cal patients. Accounts receivable for patient accounts posting PPO's, Healthy Families, and Denti-Cal payments Explanation of Benefits (EOB) - Benefit reviews through insurance companies for patients. Manual Billing for PPO's, Healthy Families, and Denti-Cal. Trace PPO's, Healthy Families, and Denti-Cal claims for status of insurance payment.

Ashworth University (General Education and Medical Billing / Claims Program)
Sacramento City College (American Sign Language)

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