Experience

Blue Cross Blue Shield of Michigan

• United States
• Insurance
• 700 & Above Employee

• Pricer VII - Claims Adjudicator

  • Oct 2010 - Present

  Adjudicate claims as the Host Plan within the Blue Cross Blue Shield Association. Written and Verbal inquires with the provider community for additional and/or missing information for claims processing. Adjudicate claims as the Host Plan within the Blue Cross Blue Shield Association. Written and Verbal inquires with the provider community for additional and/or missing information for claims processing.

• Dental Review Technician

  • Jul 1998 - Oct 2010

  Review all claims for Medical and Dental necessity. Addressed Status Inquires from providers as well as members. Served as a Customer Service Representative for Internal and External members. Claims adjudicating included foreign claim pricing for payments. Review all claims for Medical and Dental necessity. Addressed Status Inquires from providers as well as members. Served as a Customer Service Representative for Internal and External members. Claims adjudicating included foreign claim pricing for payments.



DenteMax

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Dental Review Technician

  • Apr 2008 - Jul 2009

  Customer service representative for internal and external customers, processed status inquiry claims, reviewed dental claims for medical and dental necessity. Customer service representative for internal and external customers, processed status inquiry claims, reviewed dental claims for medical and dental necessity.



University of Detroit Mercy School of Dentistry

• United States
• Higher Education
• 1 - 100 Employee

• Radiology Technician/Chairside Dental Assistant

  • Aug 1993 - Jul 1998

  Practiced four handed dentistry, assisted senior dental students with time management skills, maintained a clean and sterile work environment. Managed the Radiology department in the University Health Center. Maintained inventory, Taking, exposing, and mounting diagnostic quality radiographs. Practiced four handed dentistry, assisted senior dental students with time management skills, maintained a clean and sterile work environment. Managed the Radiology department in the University Health Center. Maintained inventory, Taking, exposing, and mounting diagnostic quality radiographs.