Samantha Marlatt
Greer,South Carolina
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
13
13
years of professional experience
Work History
Specialized Mentor And Revenue Cycle Trainer
Ensemble Health Partners-OU Health /Ardent Health
2023.06 - Current
- Developed and delivered training programs to staff in the company's policies and procedures.
- Facilitated group discussions with trainees to ensure understanding of course material.
- Conducted assessments of trainee performance, providing feedback on areas for improvement.
- Assisted with the development of a variety of instructional materials such as manuals, handouts, audio-visual aids and other resources.
- Provided guidance to trainees on best practices related to their job roles.
- Monitored progress of trainees during classes, adjusting instruction accordingly to maximize learning outcomes.
- Evaluated effectiveness of training programs by collecting feedback from participants and making necessary modifications when needed.
- Developed and coordinated trainings to help individuals learn company policies and procedures and job tasks.
- Evaluated individuals regularly for progress or growth potential to guide decisions regarding advancement and additional training.
Senior Billing Specialist
Ensemble Health Partners-Bon Secours, OU Health
2020.03 - Current
- Reviews and resolves Commercial, Medicare Managed, Medicaid Managed, Worker's Compensation, Third Party Liability, and Humana Expanded Part B : Claim Edits, Rejections, Late Charges, Consecutive and Billing Requests
- Created and maintained Billing Ticket Tracker to provide transparency to Bon Secours Billing Team on any updates regarding IT/System tickets
- Ensured the Ticket Tracker was updated every 14 days, and matched the Billing Leadership Edit/Error Dashboard that houses all Billing System Tickets/Issues
- Previously handled all Research Billing functions: Clinical Trial edit resolution in SSI and Epic
- Clinical Trial Checklist completion in compliance with Medicare/Payer regulations
- Added Research modifiers to Registry and Clinical Trial claims
- Resolved Research related denials, and rejections
- Previously handled Bone Marrow Transplant Billing: Analyzed clinical data to determine cancer treatment status in relation to Bone Marrow Transplant probability
- Compiled hospital claims, physician claims, contract language, third-party claims and other required data to provide the contracted global period billing packets/bundled billing to the payer
- Tracked Bone Marrow Transplant account from time of service to the time of account resolution, to ensure contract compliance and payment fulfillment
- Communicated with insurance payers to determine collection probability, provided additional information to the payer to process any unprocessed claims
- Tracked payer denial trends to determine overall impact of collection
- Extensive experience with Denials Management, including submitting appeals, obtaining authorization, and escalating payer issues
- Performed Monthly Deskside Audits to assess training needs, and provide coaching
- Oversaw handling of Specialty Billing/Follow-up for the following areas: Hospice, Forensic, Crime Victims, Skilled Nursing, Behavioral Health (Temporary Detention Order), Inmate Billing, Corporate/Contractual Guarantors, Third Party Liability, Worker's Compensation
- Managed and resolved Third Party Liability Negotiation requests received from Attorney Offices and Non-contracted Insurance companies in relation to Worker's Compensation and Auto Accident settlements
- Contacted Commercial insurance payers to determine the status of submitted claims
- Provided requested additional information to payers, such as medical records, itemized bills, contract language, and contract effective dates
- Reported trends related to delayed claim processing, delayed claim payment, and common denials received
- Productively met deadlines for projects assigned by upper
Lead Commercial/Specialty Insurance Follow-up Representative
Ensemble Health Partners-Bon Secours Client
2015.09 - 2020.03
- Managed and resolved Third Party Liability Negotiation requests received from Attorney Offices and Non-contracted Insurance companies in relation to Worker's Compensation and Auto Accident settlements
- Contacted Commercial insurance payers to determine the status of submitted claims
- Provided requested additional information to payers, such as medical records, itemized bills, contract language, and contract effective dates
- Reported trends related to delayed claim processing, delayed claim payment, and common denials received
- Productively met deadlines for projects assigned by upper
Insurance Follow-up Representative
Bon Secours Health System
2013.09 - 2015.09
- Managed and resolved Third Party Liability Negotiation requests received from Attorney Offices and Non-contracted Insurance companies in relation to Worker's Compensation and Auto Accident settlements
- Contacted Commercial insurance payers to determine the status of submitted claims
- Provided requested additional information to payers, such as medical records, itemized bills, contract language, and contract effective dates
- Reported trends related to delayed claim processing, delayed claim payment, and common denials received
- Productively met deadlines for projects assigned by upper
Patient Registration Representative
Bon Secours Health System-St. Francis Eastside Hospital
2011.06 - 2013.09
- Verified and entered Patient demographics, scanned insurance cards, and identification
- Performed coverage eligibility verification
- Performed patient check-ins, and provided for patient needs while waiting for appointment.
Education
High School Diploma -
Palmetto High School at Anderson, South Carolina
06.2009
Skills
- Detail Oriented
- Organized
- Transparent Communication
- Commitment to Resolution
- Resourcefulness
- Excel - Proficient
- SSI - Expert
- Epic - Expert
- Powerpoint - Proficient
- Microsoft Teams - Proficient
Timeline
Specialized Mentor And Revenue Cycle Trainer
Ensemble Health Partners-OU Health /Ardent Health
2023.06 - Current
Senior Billing Specialist
Ensemble Health Partners-Bon Secours, OU Health
2020.03 - Current
Lead Commercial/Specialty Insurance Follow-up Representative
Ensemble Health Partners-Bon Secours Client
2015.09 - 2020.03
Insurance Follow-up Representative
Bon Secours Health System
2013.09 - 2015.09
Patient Registration Representative
Bon Secours Health System-St. Francis Eastside Hospital
2011.06 - 2013.09
High School Diploma -
Palmetto High School at Anderson, South Carolina
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