Samantha Potter
New Hartford,CT
Summary
Professional in healthcare administration with strong background in managing authorization processes. Skilled in navigating complex EHR systems, understanding of ICD-10 and CPT coding procedures, prioritizing tasks and maintaining high standards of accuracy and efficiency. Familiarity with use of insurance systems to secure diagnostic authorization approvals. Reliable and coachable, with a proven track record of succeeding in varied positions within a medical office or Hospital. A friendly and motivated team player while also working competitively on an individual basis as well.
Overview
8
8
years of professional experience
Work History
Prior Authorization Specialist
Advanced Medical Imaging Center
220 Kennedy Dr Torrington Ct
03.2025 - Current
- Reviews and processes prior authorization requests for out patient medical imaging procedures to ensure compliance with insurance guidelines.
- Has developed training materials on prior authorization to assist team members or new hires within the department.
- Achieves high success rate in obtaining authorizations by analyzing medical record and effectively demonstrating medical necessity through documentation and clear communication with insurance companies.
- Maintains accurate records of authorization statuses, ensuring timely updates for patients and providers.
- Collaborates with multidisciplinary teams to gather necessary documentation to improve workflows and enhance the efficiency of authorization processes.
- Monitors pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
- Responds promptly to telephone and email inquiries on authorization details from plan members, providers and medical staff.
- Prepares and distributes denial letters, detailing reasons for denial and possible appeal measures.
- Maintains accurate records of authorization statuses, ensuring timely updates for patients, scheduling staff and providers.
- Supports team members by providing guidance on complex cases requiring detailed understanding of medical necessity criteria.
- Maintaining up to date knowledge of all insurance guidelines.
Centralized Scheduler
Charlotte Hungerford Hospital
Torrington, CT
04.2024 - 03.2025
- Collaborate with healthcare professionals to optimize patient flow and minimize delays in care delivery.
- Schedule procedures according to the providers' needs and accommodate the Patient prior to their next follow up appointment.
- Pay close attention to detail in regards to the Patient's health insurance as to schedule according to the guidelines in their policy.
- Be sure to thoroughly and courteously explain all of the requirements and preparation instructions to Patient, as well as directions to the approved medical facility.
- Interact daily with a wide range of diverse ethnicities and backgrounds while always practicing a respectful professional demeanor.
- Sort and distribute incoming faxes via both unit fax machine and electronically while managing outgoing faxes.
- Managing a high call volume and implementing my expertise to accurately resolve the Patient's needs in a timely manner.
Medical Receptionist
Pro Health Physicians
Torrington, CT
01.2021 - 04.2024
- Enhances patient satisfaction by efficiently managing the front desk operations and addressing inquiries in a timely manner.
- Successfully multi- tasking between primary care check in and discharge, as well as radiology check- in while answering phones for a high volume call center and promptly routing messages to the appropriate recipient.
- Ensures accurate record-keeping by diligently updating patient information and verifying insurance coverage.
- Training all new employees, as well as assisting my teammates and providers with daily tasks.
- Scheduling patients’ future follow up exams and various imaging appointments at the authorized facility per the providers’ order.
- Practicing daily de escalation skills while remaining courteous and professional both over the phone and in person.
- End of day payment batch reconciliation and closing responsibilities.
Receptionist
Advanced 6 Healthcare
Avon Ct
06.2017 - 11.2020
- Greeted incoming Patients and visitors professionally and provided friendly, knowledgeable assistance.
- Answered incoming calls on a high-volume, multi-line phone and pleasantly transferred callers to appropriate personnel.
- Scheduled and confirmed appointments and meetings.
- Routed incoming mail and messages to relevant personnel without delay.
- Assisted in administrative duties for office team, including making phone calls, copies and schedules.
- Assisted in billing and coding questions and inquiries.
- Successfully completed end of the day reconciliation sheet for all incoming payments, as well as prepared each deposit and managed a safe, organized file record of all payment history.
- Handled a timely response to all incoming records requests for the office.
- Quickly handled all Incoming referrals both in office as well as insurance referrals.
- Updated patient insurance and demographic information, as well as accepted in person payment transactions and entered accurately.
- Submitted patient lab orders per the Provider’s request, using appropriate test names and diagnosis codes (ICD-10).
- Prepared patient records for cardiology sonogram technician.
- Maintained an excellent bussiness relationship with our third party billing company. Helped Assist them in resolving billing issues in order to help facilitate timely reimbursement.
- Provided excellent training to all incoming employees regarding all front desk duties, policies and office procedures.
Education
Medical Administration
Porter And Chester Institute
Watertown CtSkills
- Prior authorization process
- Medical terminology
- Strong knowledge of EHR software systems including but not limited to EPIC
- Insurance verification
- Meticulous attention to detail
- Physician order verification
- HIPAA compliance
- Adaptability and flexibility
- Professional and mature
- Strong problem solver
- Self-starter
Additional Information
References availible upon request
Timeline
Prior Authorization Specialist
Advanced Medical Imaging Center
03.2025 - Current
Centralized Scheduler
Charlotte Hungerford Hospital
04.2024 - 03.2025
Medical Receptionist
Pro Health Physicians
01.2021 - 04.2024
Receptionist
Advanced 6 Healthcare
06.2017 - 11.2020
Medical Administration
Porter And Chester Institute