Kathleen Sampson
Atlanta
Summary
To gain experience with managing complex authorization processes, ensuring compliance and efficiency. Utilizes strong problem-solving abilities to streamline workflows and enhance patient satisfaction. Knowledge of industry standards and team collaboration drives successful authorization management.
Overview
17
17
years of professional experience
Work History
Outreach Care Specialist
Elevance Health
Atlanta, GA
08.2014 - Current
- Responds to customer questions or emails and written correspondents regarding insurance benefits, provider contracts, eligibility and termination of benefits.
- Handles and multitasks throughout multiple databases to research information for members to determine eligibility and terminations of State Funded programs. While in the process enrolling members or termination of members benefits.
- Provides external and internal customers with requested information.
- Maintaining fast-paced work environment and inbound and outbound calls while increasing metric standards.
- Analyzes problems and provides information/solutions
- Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
- Thoroughly documents inquiry outcomes for tracking purposes and analysis.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled properly and in a timely manner.
- Coordinated with multidisciplinary teams to ensure effective care management for members.
Front End Supervisor/Customer Service/Bartender
Kroger Company
Duluth/Atlanta, Georgia
10.2010 - 12.2018
- To provide efficient and effective customer service to ensure the best front-end company policies.
- Perform customer services at the customer service counter in accordance with Kroger operating procedures
- Assist on the Front End supervising, work at customer service, fuel center, and the floral department.
- Accountable and responsible for all money debited, collected, and deposited at the store
- Maintain well-organized, clean, pleasant shopping environment at the check stand, customer service, and parking lot area
- Help increase company sales and profits in conjunction with retail operations and marketing programs, policies, and procedures
- Conduct employee new hire orientation, also provide constructive feedback as regards to any attendance issues
- Bartender at the Bar servicing all customers and knowledge of alcohol served
Retention Specialist
Populus Group – Contractor at Amerigroup
Atlanta, GA
01.2014 - 08.2014
- Taking inbound phone calls for members who were dis enrolled from their previous health care program and offering them the benefits of our health care programs and benefits options.
- Outstanding conflict resolution, problem solving ability, ensured all questions and concerns were answered.
- Acting as liaison to the member by providing physicians and dentists in their area to ensure they would keep their same physicians and dentists.
- Tracking all the members by keeping a daily count on a spreadsheet to do follow up of members that needed follow up.
- Assist in implementing the day-to-day functions of the Finance department.
- Making outbound calls to the Hospital providers to get the balances on patient accounts.
- Maintaining accurate account balances daily.
- Finance Department (cont.)
Podiatry Service Assistant
Shiloh Medical Group LLC
Tyrone, Georgia
09.2010 - 09.2012
- Managed phone calls to verify schedules with patients and facilities.
- Addressed and checked patients vitals and medical records for each patient to be qualified to be examined by podiatrist
- Checked and documented patient vital signs
- Transported patients directly to exam rooms
- Cleaned and sanitized exam room to make appropriate for podiatrist procedure
Dental Assistant
Complete Family Dentistry
Marietta, Georgia
01.2009 - 09.2012
- Kept accurate patients records, scheduled appointments, and billed.
- Maintained patients medical documentation and health insurance, EOB, health insurance benefits for verification
- Prepared patients for examinations, treatments, surgery and prepare block for infiltration anesthesia
- Sterilized and prepared instruments trays
- Exposed and developed X-Rays
- Administered fluoride treatments
Clinical Medical Assistant Internship
Park Ridge Wellness Center
Atlanta, Georgia
10.2011 - 11.2011
- Managed patient appointment scheduling, Handled patients healthcare insurance forms, Answered multi-line phones
- Triage patients, Performed same day treatment for low/mid neck and back pains with electrotherapy and hydrotherapy equipment
Education
Classes - HIPAA & Compliance Training
Percipio
Certificate - Clinical Medical Assistant
New Life Technical Academy
Atlanta, GA12.2011
Certificate - Accounting 1
Scarlet Oaks Vocational School
Cincinnati, OH09.2003
High School - undefined
Woodward High School
Cincinnati, OH05.1987
Skills
- Clinical experience
- Obtaining/Charting vital signs
- Drug administration
- Chart preparation/Filing
- Organizational Skills
- Medical terminology
- CPR certification
- Range in motion
Timeline
Outreach Care Specialist
Elevance Health
08.2014 - Current
Retention Specialist
Populus Group – Contractor at Amerigroup
01.2014 - 08.2014
Clinical Medical Assistant Internship
Park Ridge Wellness Center
10.2011 - 11.2011
Front End Supervisor/Customer Service/Bartender
Kroger Company
10.2010 - 12.2018
Podiatry Service Assistant
Shiloh Medical Group LLC
09.2010 - 09.2012
Dental Assistant
Complete Family Dentistry
01.2009 - 09.2012
Certificate - Clinical Medical Assistant
New Life Technical Academy
Certificate - Accounting 1
Scarlet Oaks Vocational School
High School - undefined
Woodward High School
Classes - HIPAA & Compliance Training
Percipio
Section name
Software: Avaya; Facets; GAMMIS; GAHIN; Member360; CaseTracker; Genesys Cloud; HIP; Thought Spot.