Open Dental
Prdyuman Thakur
Process Associate
Mohali
Summary
Dynamic Senior Process Associate at Accubills Healthcare with expertise in insurance verification and revenue cycle management. Proven ability to enhance patient satisfaction through effective communication and meticulous attention to detail. Skilled in managing pre-treatment authorizations and resolving denied claims, ensuring optimal reimbursement and compliance.
Overview
1
1
year of professional experience
3
3
Languages
Work History
Senior Process Associate
Accubills Healthcare
12.2025 - Current
- Process-driven Dental Insurance Coordinator skilled in verifying eligibility for complex dental procedures and enhancing revenue cycle management. Adept at navigating insurance portals and collaborating with clinical staff to ensure maximum reimbursement. Committed to reducing patient wait times and improving patient satisfaction through clear, empathetic communication regarding coverage.
- Software: Dentrix, Eaglesoft, Open Dental, Payer Portals (e.g., Availity, Delta Dental)
- Technical: Insurance Verification (Breakdowns), Prior Authorizations, Coding (CDT/ICD-10), Claim Troubleshooting
- Soft Skills: Attention to Detail, Communication, Time Management, Patient Counseling
Dental IV Analyst
Wenour Enterprises Pvt Ltd
05.2025 - 11.2025
- Comprehensive Breakdowns: Conducted detailed insurance breakdowns, including annual maximums, remaining benefits, deductibles, and non-covered services (e.g., waiting periods, frequency limits).
- Payer Communication: Contacted insurance carriers via phone, fax, and online portals (e.g., Delta Dental, Aetna, Cigna, UnitedHealthcare) to resolve eligibility issues and verify coverage.
- Software Proficiency: Accurately entered verified insurance details, including plan limitations and fee schedules, into dental practice management software (e.g., Dentrix, Eaglesoft, Open Dental, Curve).
- Pre-authorization Management: Coordinated with provider offices to obtain prior authorizations and pre-determinations for major procedures (crowns, implants, bridges) to ensure timely approval.
- Revenue Enhancement: Identified and escalated policy limitations (e.g., frequency limits, missing tooth clauses, downgrades) to front office staff, preventing billing discrepancies and reducing accounts receivable.
Education
High School Diploma -
Government Senior Secondary School
Hamirpur, India05-2022
Skills
- Skilled in conducting insurance verification via phone and online
- Evaluation of healthcare plan structures
- Skilled in using Dentrix, Eaglesoft, and Open Dental
- Ability to estimate coverage using CDT codes
- Expert in managing pre-treatment authorizations
- Research and analysis of denied claims
Software
EagleSoft
Timeline
Senior Process Associate
Accubills Healthcare
12.2025 - Current
Dental IV Analyst
Wenour Enterprises Pvt Ltd
05.2025 - 11.2025
High School Diploma -
Government Senior Secondary School