Mifta Kishwar Mahmud

Detail-oriented Dental Insurance and Billing Professional with 6 years of dental office experience and progressive expertise in dental billing, insurance coordination, claims management, and revenue cycle management (RCM). Experienced in supporting insurance and billing operations for a high-volume dental practice serving 400+ patients weekly, with a strong focus on accuracy, reimbursement efficiency, and accounts receivable management. Skilled in insurance eligibility and benefits verification, dental claim preparation and entry, CDT coding, predeterminations, coordination of benefits (COB), Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) processing, payment posting and reconciliation, accounts receivable (A/R) follow-up, denial management, and insurance claim resolution.

Certified Dental Billing

Specialist (CDBS) and active member of the American Dental Coders Association (ADCA). Proficient in Open Dental, Zocdoc, ePrescribe, InstaMed, and CareCredit, with additional working experience in EZDent, Dentrix, Cherry, and Weave.

Dental Billing Specialist & Insurance Coordinator - HIGHLINE DENTAL PRACTICE - Chelsea, New York

(2025-02)

• Insurance Verification & Eligibility: Verify in- and out-of-network PPO coverage, insurance eligibility, plan benefits, deductibles, annual maximums, coinsurance, frequency limitations, and coverage restrictions for a high-volume dental practice serving 400+ patients weekly.
• Predeterminations & Preauthorizations: Prepare, submit, track, and follow up on insurance predeterminations and preauthorization requests, including CDT procedure codes, supporting clinical documentation, and coverage determinations.
• Treatment Planning & Financial Coordination: Create, prepare, and present comprehensive dental treatment plans for patients and clinical staff. Calculate estimated insurance benefits and out-of-pocket expenses, explain financial responsibilities, and coordinate financing options through CareCredit, Cherry, and in-house payment plans.
• Dental Claims Processing & Payment Reconciliation: Prepare and enter dental insurance claims and calculate insurance reimbursements according to patient responsibility, deductibles, annual maximums, and alternate benefits. Review EOBs/ERAs, post insurance payments, apply contractual adjustments, reconcile patient ledgers, and identify reimbursement discrepancies.
• Denial Management & Claim Resolution: Investigate denied, rejected, delayed, and underpaid claims; identify coding, eligibility, and payment discrepancies. Communicate directly with insurance carriers and/or patients to resolve coverage issues, correct claim information, and facilitate timely reimbursement.
• Accounts Receivable (A/R) & Patient Collections: Monitor aging claims, outstanding insurance balances, and unpaid reimbursements. Conduct insurance follow-ups, collect copayments and outstanding patient balances, process financial transactions, and maintain accurate patient accounts to support revenue cycle management (RCM).
• HIPAA Compliance & Documentation: Maintain accurate electronic patient records, insurance documentation, billing records, and financial transactions while safeguarding PHI in accordance with HIPAA privacy and security regulations.

Insurance & Treatment Care Coordinator - HIGHLINE DENTAL PRACTICE - Chelsea, New York

(2024-02 - 2025-01)

Front Desk Specialist - HIGHLINE DENTAL PRACTICE - Chelsea, New York

(2023-02 - 2024-01)

Dental Receptionist - DR. LILIYA ETKINA, DDS - Long Island City, Queens

(2019-06 - 2022-11)

• Insurance Verification & Benefits Coordination: Verified dental insurance eligibility, coverage, copayments, deductibles, and benefits for diagnostic, preventive, and emergency dental procedures.
• Patient Account Management: Created, updated, and maintained electronic patient records, insurance information, and account details using Dentrix.
• High-Volume Scheduling: Managed appointment scheduling, confirmations, cancellations, and patient follow-ups for a dental practice serving 100+ patients weekly.
• Practice Management Software: Utilized Dentrix and Zocdoc for appointment scheduling, patient communication, and electronic record management.
• Scheduling & Workflow Optimization: Implemented an improved scheduling system to streamline appointment coordination, reduce patient wait times, and improve office efficiency.
• Patient Communication & Coordination: Managed incoming calls, appointment inquiries, insurance questions, and patient correspondence via phone and email.
• HIPAA Compliance & Documentation: Maintained accurate electronic patient records, insurance documentation, and confidential patient information in accordance with HIPAA regulations.
• Administrative Operations: Coordinated daily front-office workflow, patient registration, and administrative recordkeeping to support efficient practice operations.

28 credits toward bachelor's degree - Business - CUNY Baruch College, Zicklin School of Business (2011 - 2012)

LLB program - London College of Legal Studies, University of London (2010 - 2010)