Katie Jacobson
Benson,NC
Summary
Experienced Dental Hygienist with a strong focus on efficiently processing dental prior approval requests for Medicaid. Maintained quality control for a team of nineteen examiners, ensuring accuracy and adherence to guidelines. Skilled in researching and resolving appealed cases and performing mediations to reach fair resolutions. Extensive experience working with NCTracks and a deep understanding of the intricacies of these systems, enabling seamless navigation and effective coordination.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Healthcare Claims Examiner, Senior-QC
General Dynamics Information Technology Inc
06.2024 - Current
- Handled sensitive information with discretion, ensuring confidentiality of personal and work details for staff throughout second review processes.
- Participated in cross-functional team meetings to address organizational challenges related to quality control.
- Reduced reviewer processing errors by implementing efficient workflow strategies via email.
- Served as a mentor to junior examiners, sharing expertise and providing guidance on best practices to efficiently process prior approval requests.
- Maintained detailed records/reviews of nineteen examiners for each month, ensuring compliance with processing dental and orthodontic requests.
Healthcare Claims Examiner
General Dynamics Information Technology Inc
07.2021 - 06.2024
- Cross train on at least one additional operational process
- Front line staff identify and share process improvements to their functional area, member or customer wins, and success stories with manager/supervisor
- Accurate tracking and reporting of timekeeping
- Active and timely participation and completion of all required trainings and meeting attendance
- Career Profile maintenance once/year minimum
- Use GDIT processes, tools, and methodologies (OPS manual, desktop procedures, policy interpretations, and general grammar understanding) to ensure accuracy and quality of work
- Process improvements implemented (desktop procedures being followed; workflow assignments)
- Minimum number of Prior Approvals completed per day (benchmarks measured on performance report)
- Productivity spreadsheet based on weekly status reports and monthly report of work completed
- Completion of new certifications, professional and networking relationships, completion of career related training courses or workshops, joining and actively participating in professional organizations
- Completion of one diversity and inclusion related learning module or workshop/seminar
Dental Hygienist
Riccobene Associates Family Dentistry
06.2018 - 07.2021
- Performing all dental hygiene duties
- Discussing treatment plans/scheduling patients
- Discussing insurance/breakdown with patients
- Sterilization knowledge
- Discussing Medicaid covered procedures
Dental Hygienist
Southern Village Dental
10.2017 - 06.2018
- Performing all dental hygiene duties
- Discussing treatment plans/scheduling patients
- Discussing insurance/breakdown with patients
- Sterilization knowledge
Pharmacy Technician
CVS Pharmacy
01.2013 - 01.2014
- Took prescriptions and dispensed the appropriate medicines
- Answered phone calls from doctors, and customers
Education
ASSOCIATE - ASSOCIATES OF APPLIED SCIENCE IN DENTAL HYGIENE
Wake Technical Community College
Raleigh, NC05.2017
COMPLETED COURSEWORK TOWARDS CPR
Wake Technical Community College
COMPLETED COURSEWORK TOWARDS INFECTION CONTROL
Wake Technical Community College
Skills
- Claims Understanding
- Document And Policy Review
- Spreadsheet Tracking
- Conflict Mediation
- Insurance Terminology
- Microsoft Office
- Prior Authorization Processing
- Benefit Coverage
- Clinical Messaging
- Diagnostic Codes
- Problem Resolution
- Treatment Documentation
- Retro-Authorizations
- Quality control
Certification
- Certifications and Licenses for Registered Dental Hygienist
- CPR/BLS
- National Board Dental Hygiene Exam
- Clinical Dental Hygiene Exam
Additional Information - Work Authorization
Authorized to work in the US for any employer
Timeline
Healthcare Claims Examiner, Senior-QC
General Dynamics Information Technology Inc
06.2024 - Current
Healthcare Claims Examiner
General Dynamics Information Technology Inc
07.2021 - 06.2024
Dental Hygienist
Riccobene Associates Family Dentistry
06.2018 - 07.2021
Dental Hygienist
Southern Village Dental
10.2017 - 06.2018
Pharmacy Technician
CVS Pharmacy
01.2013 - 01.2014
COMPLETED COURSEWORK TOWARDS CPR
Wake Technical Community College
COMPLETED COURSEWORK TOWARDS INFECTION CONTROL
Wake Technical Community College
ASSOCIATE - ASSOCIATES OF APPLIED SCIENCE IN DENTAL HYGIENE
Wake Technical Community College
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