Samantha O'Mara
New Iberia,LA
Summary
Confident Medical Biller motivated to perform beyond expectations. Detail-oriented with focus on deadlines and skilled in handling medical billing and insurance collections without errors. Talented at deciphering complex claim denials and obtaining payment by making corrections or submitting appeals.
Overview
11
11
years of professional experience
Work History
Follow-Up Medical Biller
Iberia Medical Center
New Iberia, LA
03.2018 - Current
- Resolved complex Medicaid accounts that were over 120 days old by applying extensive knowledge of Medicaid's regulations.
- Handled initial billing and insurance collections of all inpatient psych claims for all payers, including commercial, Medicare Advantage Plans, Medicare and Medicaid.
- Handled initial billing and insurance collections of all Medicaid claims filed on CMS 1500 forms.
- Communicated with insurance providers to resolve denied claims by submitting disputes and appeals or correcting errors and refiling.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
- Adhered to established standards to safeguard patients' health information.
Licensed Life and Health Insurance Professional
Transamerica Life Insurance Company
New Iberia, LA
07.2015 - 03.2018
- Customized existing insurance programs to suit individual client needs by analyzing specific requirements.
- Sought out new clients and developed client relationships through networking, direct referrals, lead databases and cold calling.
- Reviewed policy applications for errors and liaised with underwriters to facilitate quick completion of application process.
- Quoted and calculated premium rates for policies.
- Determined financial needs by assessing existing coverage and aligning new products and services with long-term goals.
- Worked with sales team to collaboratively reach targets, consistently meeting or exceeding personal quotas.
Marketing Director
Nexion Health Care
New Iberia, LA
08.2014 - 06.2015
- Supported marketing teams, creating, deploying and optimizing campaigns for our nursing care facility.
- Prepared and executed outreach events designed to engage our community and generate referrals.
- Cultivated professional relationships with healthcare providers in the region, ensuring that our facility's census stayed at or above our goal.
- Managed annual marketing budget.
- Directed a marketing team of seven to reach facility referral goals.
- Served as a liaison between families of our residents and the facility.
- Reviewed medical records and met with potential residents to help ensure that our facility was a good fit to meet their specific needs.
Coder/Medical Biller
Franklin Foundation Hospital
Franklin, LA
12.2012 - 08.2014
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Used CPSI and 3M to assign procedure and diagnostic codes to patient records for billing purposes.
- Processed insurance company denials by auditing patient files and researching procedures and diagnostic codes to determine proper reimbursement.
- Successfully evaluated insurance denials to determine to proper action to obtain payment.
- Initiated the patient collections process for delinquent accounts.
Dental Office Manager
Wilmington Comprehensive Dentistry
Wilmington, NC
07.2008 - 02.2010
- Oversaw facilities and equipment cleanliness and safety for optimal patient protections.
- Prepared insurance claim forms, explained benefits and outlined pricing details for procedures and services.
- Reviewed reports, prepared bank deposits and posted daily revenues to stay on top of administrative demands.
- Supervised and led team of dental hygienist and support staff.
- Maintained patient data with required regulatory chart documents, personal information and treatment consultation documentation.
- Increased and stimulated new patient growth by supporting sales, marketing and promotional programs.
- Interceded between employees during arguments and diffused tense situations.
- Monitored front areas so that questions could be promptly addressed.
Education
No Degree - English
University of Louisiana At Lafayette
Lafayette, LAHigh School Diploma -
Berwick High School
Berwick, LA05.1998
Skills
- Verbal and Written Communication
- ICD-10 and CPT Navigation
- Billing Data Verification
- Discrepancy Resolution
- Services Rendered Documentation
- Data Analysis and Organization
- Microsoft Office
- Thorough Knowledge of Louisiana Medicaid Program
- Disputes/Appeals of Insurance Denials
Timeline
Follow-Up Medical Biller
Iberia Medical Center
03.2018 - Current
Licensed Life and Health Insurance Professional
Transamerica Life Insurance Company
07.2015 - 03.2018
Marketing Director
Nexion Health Care
08.2014 - 06.2015
Coder/Medical Biller
Franklin Foundation Hospital
12.2012 - 08.2014
Dental Office Manager
Wilmington Comprehensive Dentistry
07.2008 - 02.2010
No Degree - English
University of Louisiana At Lafayette
High School Diploma -
Berwick High School