Samantha Langford

Billing & Revenue Cycle Management

• Coordinated and validated patient payments across EHR and accounting platforms, maintaining financial accuracy with Excel-based tracking tools.
• Posted and reconciled insurance payments using platforms such as Availity, Zelis, InstaMed, and Optum Bank; manually entered EOB data when necessary to ensure complete records.
• Cross-verified client payments across Bremer Bank, Heartland, and internal systems to uphold fiscal consistency.
• Audited monthly Aging Reports to identify delinquent claims (60+ days), investigated filings beyond payer deadlines, and resolved discrepancies to recover revenue.
• Acted as primary liaison to insurance providers (e.g., BCBS, UHC, Medica, MA, Medicare), handling claims resolution, EOB clarification, and credentialing communication.
• Leveraged Availity for electronic claims submissions, eligibility verification, and denial prevention.
• Reviewed and batched Dates of Service (DOS) and insurance claims; corrected coding issues (modifiers, CPT mismatches) to reduce denials.
• Verified patient insurance eligibility, including coverage breakdowns, deductibles, and authorization requirements.
• Created and issued customized welcome packets to new and returning clients, detailing insurance information, payment plans, and sliding fee options.

Client Billing & Financial Communications

• Generated and audited client billing statements for accuracy, applying tailored messaging per billing stage (First Notice, Final Notice, Financial Hold, Discharge).
• Streamlined the statement process—reducing turnaround from 7+ days to just 1—by implementing efficient workflows.
• Managed statement distribution for over 800 clients, averaging 300+ monthly via mail and email.
• Conducted payment follow-ups through phone and email to resolve outstanding balances and answer billing inquiries.
• Processed all on-site financial transactions, including auto-payments and bank deposits for cash/check payments.

Credentialing & Compliance Oversight

• Credentialed new clinicians using MCC, CAQH, and insurer-specific documentation; ensured adherence to Medicare and Medical Assistance standards.
• Directed ongoing recredentialing processes and updated insurance carriers on provider status changes, ensuring continuous payer participation and compliance.

Front Desk & Patient Coordination

• Oversaw front desk operations, ensuring smooth patient check-in/check-out with a focus on delivering responsive, high-quality service in a fast-paced clinical setting.
• Assembled and prepped patient charts up to three days in advance, expediting intake and promoting accurate clinical documentation.
• Digitized and uploaded essential documents—including insurance cards, photo IDs, and consent forms—into the system for real-time access and record completeness.
• Enforced COVID-19 safety protocols by administering pre-entry vitals and coordinating safe clinic access.

Billing & Insurance Verification

• Collected and recorded patient payments, including copays and outstanding balances, ensuring accurate point-of-service financial reconciliation.
• Submitted claims through Office Mate software directly after appointments, accelerating reimbursement turnaround and minimizing delays.
• Performed in-depth insurance verification, confirming coverage details and proactively identifying potential billing conflicts to reduce denials.
• Organized and prepped patient billing files for upcoming business days, reinforcing operational readiness and supporting seamless clinic-billing collaboration.

Provided third-party billing support across 10 medical clinics with a wide range of specialties, including general practice, mental health, and workers’ compensation. Entered and managed patient data within four EHR systems, most notably CollaborateMD, and verified insurance eligibility using integrated tools. Published both electronic and paper claims, edited CPT and diagnosis coding for accuracy, and resolved claim denials through EOB analysis and appeals. Billed secondary and tertiary insurances, processed missing documentation, and researched billing protocols for obscure insurance plans. Served as the first point of contact for all incoming patient and provider billing inquiries across partner clinics.