Samantha Smith
St. Louis,Mo
Summary
Seasoned Business Analyst offering 22 years of Health Care and Revenue Cycle Management industry success. Collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Knowledgeable with business and systems requirements, user acceptance testing and end-user training. Diligent worker with strong communication and task prioritization skills. Accomplished at leveraging past lessons to inform future decision-making.
Overview
17
17
years of professional experience
Work History
RCM BUSINESS ANALYST
BJC Health
St Louis, MO
08.2014 - Current
- Review payments received and analyze for potential impact to revenue
- Determine plans of action for staff to ensure more efficient completion of worklists
- Serve as liaison for staff and management regarding reports and payor communications
- Analyze adjustments applied and initiate plans of action for avoidance of future loss
- Track monthly production results for staff and establish metrics for prime performance
- Perform monthly audits on staff and recognize training opportunities.
- Assisting with lowering gross claim volume to under 8%
- Created RTP Reports to track gross dollars volumes
Denial Patient Representative II
MERCY Hospital
St Louis, MO
05.2012 - 08.2014
- Processed payment discrepancies and identified variances and researched contract terms for Medicare, Medicaid and Manage Care
- Performed analysis and tracked trends of discrepancies for accounts above $500.00 threshold
- Initiated and pursued appeals daily
- Recognized and resolved denial patterns while communicating with management
- Confirmed payments received in agreement with contracted rates
- Initiated and completed appeals for contract compliance.
Team Leader
MEDICAL WEST RESPIRATORY Billing
St Louis, MO
05.2009 - 08.2014
- Processed payment discrepancies and identified variances and researched contract terms
- Delegate and determine daily task/responsibilities among 25 oximeter team members
- Analyze individual and team performances as well as motivate team to improve where needed
- Review and update department protocol
- Coordinate and communicate with company sales team and doctor offices regarding department policy changes and updates
- Report department issues to company manager and/or supervisor
- Offer assistance in decisions based on improving department goals
- Responsible for completion of uncompleted department task/duties
- DME equipment registration for patients within Missouri and Illinois
- Responsible for daily office operations
- Scheduling
- Verified insurance and benefits for all Medical West patients (familiar with Medicare, Medicaid, United Healthcare/ UMR, Tri-Care, and BCBS)
Student Intern
Mercy Hospital St. Louis
St Louis, MO
06.2003 - 06.2005
- Reported back to Human Resources manager to receive day-to-day tasks and responsibilities.
- Communicated effectively with staff and accepted critiques and suggestions for areas of improvement.
- Gained operational knowledge and supported departmental needs.
- Performed administrative duties and staff support tasks.
- Human resource duties including entering 50 or more applicant’s information into ATS daily
- Assisted in registering new hires for informational workshops and orientation
Education
MHA-Degree - Progress
Webster University
St Louis, MO12.2022
MBA - Health Administration
Webster University
St Louis, MO05.2020
B.A - Management
Webster University St
2008
Skills
- Account Analysis
- Revenue Cycle Management
- Contract Review
- Quality Audits - Production Tracking
- Variance Analysis
- Customer Communication
- Business Requirements
- Customer Monitoring
- Compiling Data
- Health Information Policy and Procedure Development
- Administration and Management
- Business Processes and Procedures
Affiliations
Phi Ne Kappa Sorority, Incorporated
Webster University -Walker School Women in Business Network
Timeline
RCM BUSINESS ANALYST
BJC Health
08.2014 - Current
Denial Patient Representative II
MERCY Hospital
05.2012 - 08.2014
Team Leader
MEDICAL WEST RESPIRATORY Billing
05.2009 - 08.2014
Student Intern
Mercy Hospital St. Louis
06.2003 - 06.2005
MHA-Degree - Progress
Webster University
MBA - Health Administration
Webster University
B.A - Management
Webster University St