New York, NY

Position Desired

Other Healthcare Administration
New York, NY


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.
 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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