Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Hind Niri

Home N-16, Way 2321 South Hail, Seeb,Muscat

Summary

Detail-oriented Examiner with 9 years of background experience in dentistry. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills, auditing dental records to evaluate the accuracy of dental coding and health plan policies for our Fraud & Abuse clients. education on ICD-10, HCPCS and CPT codes. Trustworthy and dependable.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Dental Claim Auditor

Wellmed Medical Group
04.2022 - 01.2024
  • Identified control gaps in processes, procedures and systems through in-depth research and assessment and suggested methods for improvement.
  • Obtained and interpreted relevant and authoritative criteria for program or issues under audit.
  • Interpreted state and federal laws, accepted auditing principles and procedures and program standards to audited materials and data to detect non-compliance and facilitate recommendations.
  • Planned and executed follow-up audits at appropriate intervals.

General Dentist

My Own Clinic
09.2015 - 08.2022
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures for claims
  • Collaborated with dental specialists, such as orthodontists and
    periodontists, to provide comprehensive care to patients
    Stayed up-to-date with the latest advancements in dentistry and regularly attended continuing education courses.
  • Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
  • Verified client information by analyzing existing evidence on file.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.

General Dentist

Public Hospital
06.2013 - 06.2015
  • I worked in public dental clinic for 2 years as General Dentist, then I opened my own dental clinic, where i worked as principal General Dentist and succeed to mange and supervise my team in term of ; accurate data entries at reception, guiding nurses, collaborate with Dental Specialist and dental lab.
  • Comprehensive diagnosis and treatment of acute and chronic dental diseases, injuries and malformations of teeth and gums, treatment plan, diagnose and treat dental emergencies.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
  • Evaluated performance of all clinical staff to deliver constructive feedback and acknowledge strengths resulting in better working relationships and performance improvements.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Verified client information by analyzing existing evidence on file.

Education

Certificate of Dental Implantation - Dental Implantation

Training Certificate in Clinical Implantation
Clinical Implant Training Concept Center
02-2019

Bachelor of Science - Dentistry

Dental Surgeon Diploma
University Of Saad Dahlab
06-2008

Skills

  • Claims Auditing
  • Negotiation and mediation skills
  • Familiar with fraud statutes
  • Healthcare Common Procedures Coding System (HCPCS)
  • Insurance policy coverage knowledge
  • Data Analytics
  • Attention to detail and a high level of accuracy
  • Effective organizational and prioritization skills with multi-tasking ability
  • Detail oriented, organized, process focused, problem solver, proactive, ambitious, customer service focused
  • Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, and other members of the business community
  • Analytical skills to synthesize complex or diverse information Ability to research information and analyze data to arrive at valid conclusions, recommendations, and plans of action

Accomplishments

  • Coach and train dental students on scaling, anesthesia technics, teeth extraction and canal treatment.

Certification

  • Attended DENTEX Congress arranged by International Conference Center of Algiers, 2016, 2017, 2019, 2020, 2021. 2022.

  • Certificate of attendance in the 7th exclusive congress of Oral implantology. 30th June 2012.

Timeline

Dental Claim Auditor

Wellmed Medical Group
04.2022 - 01.2024

General Dentist

My Own Clinic
09.2015 - 08.2022

General Dentist

Public Hospital
06.2013 - 06.2015

Certificate of Dental Implantation - Dental Implantation

Training Certificate in Clinical Implantation

Bachelor of Science - Dentistry

Dental Surgeon Diploma

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Hind Niri