Summary
Overview
Work History
Education
Skills
Timeline
Generic

Samantha Hollis

Elburn,IL

Summary

Results-driven Senior Analyst with over 20 years of experience in healthcare revenue cycle operations. Detail-oriented and meticulous, with a proven track record in analyzing Medicare and Medicaid policies to provide strategic recommendations that enhance operational efficiencies for membership hospitals. Expertise includes optimizing processes, improving billing and collections, and driving reimbursement through data-driven insights.

Overview

26
26
years of professional experience

Work History

Senior Analyst for PFS Health Policy and Finance

Illinois Health and Hospital Association
04.2024 - Current
  • I Addressed key revenue cycle issues by conducting in-depth research on Medicare, Medicaid and commercial payer policies thus help Improving PFS membership claim denial rates overall.
  • I Validated claim billing errors brought up by membership by utilizing my technical expertise, resolving in whether a billing system programming is needed or if in-fact a discrepancy exists with an insurance.
  • I analyzed payment trends from specific insurance companies, identifying patterns that indicated underpayment issues. This analysis led to discussions with stakeholders and the implementation of a review of the insurance pricing system, resulting in more accurate pricing strategies and improved reimbursement rates.
  • Extracting data from multiple sources to track and analyze billing payment policies and regulatory developments for Medicare, Medicaid, and
    commercial payers, emphasizing key issues that impact Hospital Revenue Cycle/PFS members.
  • Maintain a comprehensive repository of inquiries from members and corresponding responses from staff.
  • Research, resolve or propose resolution to complex and/or other technical inquiries assigned by Director.
  • Assist in obtaining resolutions from the appropriate government agencies or commercial payers for PFS membership.
  • Outreach and Collaboration with stakeholders Coordinate and run monthly PFS member hospital requested meetings with customized reports and agendas.
  • Assist with implementing services, programs, surveys, and projects to achieve PFS department objectives. Perform survey analysis and communicate survey results to PFS members.

Analyst for Patient Financial Services

Illinois Health and Hospital Association
04.2019 - 03.2024
  • Researching and providing technical operational support to PFS member hospitals on revenue cycle issues.
  • Review of current hospital operational issues with Insurance companies every month; while providing support for utilization review, registration access, and patient financial service committee meetings on revenue cycle topics.
  • Working ad-hoc with policy team members on various crossing issues.
  • Develop and maintain a master database list of technical inquiries with staff responses.
  • Track and analyze Medicare, Medicaid, and Commercial payer regulatory developments and highlight key issues affecting PFS members and help distribute the information via committee meetings, newsletters, or memo blasts.
  • Apply technical expertise to validate claim adjudication errors identified by members before presenting to Insurance for resolution.

Medicare Operational Coordinator Billing /Collections

Northwestern Medicine
03.2018 - 04.2019
  • I Analyzed billing data to identify patterns of billing errors, leading to a 20% reduction in claim denials by implementing targeted training for billing staff.
  • Guiding the Medicare team in identifying and resolving billing, collection, and reimbursement issues.
  • I reported weekly productivity and quality measurements to management.
  • Implemented innovative programs to increase employee loyalty and reduce turnover.
  • Assisted management in maintaining policies, procedures, and objectives for the team.
  • I reviewed and assigned work to staff regarding CFB, ATB, and vendor requests.
  • Oversaw the daily claims import and balancing of clearinghouses.
  • Communicated effectively with various hospital departments to resolve billing, coding, and other
    internal issues.

Government Billing/Collections Lead

Cadence Health/ Northwestern Medicine
01.2014 - 03.2018
  • I supported staff in adhering to proper procedures to ensure compliance with Medicare and
    Medicaid regulations.
  • I identified and resolved various types of billing issues and errors associated with billing and
    reimbursement processes.
  • I trained new hires and provided ongoing training for current employees on the Epic billing system.
  • Working with outsourced vendors for additional or missed reimbursement for Medicare claims.

Government Billing/Collection

Cadence Health
01.2013 - 01.2014
  • Working with a multitude of contacts within the hospital to fix and apprehend edits and/or errors like CCI, OCE, MUE, and LMRP on claims to ensure clean billing.
  • Using Fss0, Nebo, Epic, thin online, and a variety of systems to do daily billing, rebilling, and checking of government claims.
  • Importing and balancing claims files daily from the hospital-billing database (Epic) to our clearinghouse (Nebo).
  • Conversations with our I.T. and Nebo simultaneously if claim files were not placed correctly.
  • Working and transferring legacy files to vender for runoff due to merger.
  • Reports for management, and all other billing functions i.e. transmitting, statusing, and reconciling

Revenue Cycle Engineering Analyst

Delnor Community-Hospital / Cadence Health
01.2012 - 01.2013
  • Served as the project liaison between the vendor Navin Haffty & Associates and Cadence Health,
    facilitating the transition from the primary billing database (Meditech system) through the systematic
    exchange and review of files between systems.
  • Engaged with applications pertaining to charging, billing, and coding processes.
  • Handled the importing claims to our clearinghouse (Nebo) daily.
  • Involved in the analyst aspect of EPIC build for the revenue cycle.

Medicare specialist

Delnor Community-Hospital
12.2004 - 01.2012
  • Posting all insurance correspondence from Zero pays, additional information requested down to duplicate claims. ECT.
  • Reviewing hospital-wide medical necessity issues and creating process improvement with the clinical departments and customer service.
  • Oversaw the billing and collection processes for all Medicare claim forms, including UB 837I and 1500 837P, while managing aging trial balance reports.
  • Heavy involvement in process improvement due to Delnor and central DuPage merger.

Medicare Specialist / Cerner expert, trainer

Sherman Health Systems
01.2004 - 12.2004
  • Participated in the build and testing of the new Cerner computer system for Sherman Hospital,
    including travel to Kansas City for training and system testing.
  • Returned with comprehensive knowledge to coordinate training sessions for the billing department
    staff.
  • Led the implementation of the system while addressing and resolving operational issues within
    billing processes.
  • Collaborated closely with the Patient Accounts Manager and the department director to facilitate the
    integration of the Cerner system.

Medicare Specialist

Sherman Health systems
12.1999 - 01.2004
  • The daily billing and follow-up on Medicare Prime, as well as Medicare secondary accounts.
  • Working all types of Medicare reporting to ensure all bills leaving the building promptly.
  • Reviewing contract adjustments and posting accordingly while checking for proper Medicare reimbursement.


Registration / Scheduling

Sherman Health systems
05.1999 - 12.1999
  • Checking in patients via in person and or over the phone, reviewing and correcting demographic information.
  • Adding correct insurance information for proper billing. In addition to all other types of responsibilities done by the registration/scheduling staff.

Education

Associate of Applied Science - Business Administration

Elgin Community College
Elgin, IL
05.2003

Skills

  • I have an In-depth understanding of regulations, reimbursement requirements, and policy implementation analysis
  • I am skilled in X12 formats, including 837P and 837I; adept in using the OCE editor
  • I have a comprehensive knowledge of LCD/NCDs, HCPCS, CPT, and ICD-10/PCS
  • I am Experienced in analyzing complex datasets to drive decision-making and improve operational efficiencies
  • Very proficient in collecting and tracking different data elements across various platforms
  • Well-versed in systems such as Epic, Experian, Cerner, Meditech, Compass, Connex, and NGS/ASF/FSS
  • I am Effective in organizing and facilitating meetings to ensure alignment and progress on projects
  • Very adept at building strong client relationships and delivering exceptional service to meet client needs

Timeline

Senior Analyst for PFS Health Policy and Finance

Illinois Health and Hospital Association
04.2024 - Current

Analyst for Patient Financial Services

Illinois Health and Hospital Association
04.2019 - 03.2024

Medicare Operational Coordinator Billing /Collections

Northwestern Medicine
03.2018 - 04.2019

Government Billing/Collections Lead

Cadence Health/ Northwestern Medicine
01.2014 - 03.2018

Government Billing/Collection

Cadence Health
01.2013 - 01.2014

Revenue Cycle Engineering Analyst

Delnor Community-Hospital / Cadence Health
01.2012 - 01.2013

Medicare specialist

Delnor Community-Hospital
12.2004 - 01.2012

Medicare Specialist / Cerner expert, trainer

Sherman Health Systems
01.2004 - 12.2004

Medicare Specialist

Sherman Health systems
12.1999 - 01.2004

Registration / Scheduling

Sherman Health systems
05.1999 - 12.1999

Associate of Applied Science - Business Administration

Elgin Community College