Objective:
To secure a job position to provide dependable and efficient virtual support to healthcare professionals and ensuring smooth administrative operations and quality patient coordination in a remote setting.
Handling inbound calls
from patients and providers regarding benefits, eligibility, claims, prior
authorizations, and appeals specific to U.S. dental plans.
Initiating outbound
calls to follow up on pending cases, requesting missing documentation
(narratives of necessity, x-rays, periodontal charting), and ensuring
timely claims and prior authorization processing.
Coordinating
appointment scheduling for patients especially for Medicare and Medicaid
patients by liaising with U.S. dental offices.
Supporting technical
issues involving access to dental self-service platforms, enhancing member
experience through guided troubleshooting.
Fulfilling document
requests via fax, including EOBs, eligibility and benefit details, and
pre-authorization copies.
Educating dental
providers on U.S. claims submission processes, clinical documentation
standards, and pathways to becoming an in-network provider.
Explaining major
procedure guidelines in accordance with U.S. dental coverage requirements.
Upholding HIPAA
regulations in all communications and tasks to protect patient and
provider data and ensure full compliance with federal privacy
standards.
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<!--[endif]-->Conducted training for new hires and existing agents
on dental provider support, insurance claims and patient services to ensure
workforce efficiency.
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<!--[endif]-->Led upskill and refresher training to address
insurance updates, plan changes and client-specific workflows.
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<!--[endif]-->Collaborated with quality assurance and operations
teams to close performance gaps and improve CSAT and FCR scores.
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<!--[endif]-->Performed call calibrations, mock calls and live
shadowing for readiness assessment and agent coaching.
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<!--[endif]-->Designed and updated training manuals, call scripts
and quality benchmarks tailored to dental operations.
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<!--[endif]-->Trained agents on using and navigating dental tools
and software.
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<!--[endif]-->Ensured adherence to HIPAA and data privacy standards
in all patient interactions and documentation.
