SAMANTHA NICOLE QUINN
Newark,NJ
Summary
Reimbursement specialist with comprehensive experience in managing medical billing and prior authorization processes. Expertise in coordinating with insurance carriers to secure patient benefits while providing guidance to staff, ensuring accurate documentation and enhancing overall efficiency in healthcare operations.
Overview
2
2
Languages
1
1
Certification
6
6
years of professional experience
Work History
Reimbursement Specialist
Cornerstone Staffing LLC
05.2023 - 02.2024
- Contacted insurance carriers to secure patient medical benefits for specialty medications, ensuring access to necessary treatments.
- Engaged with insurance providers to verify customer policy benefits for claims, facilitating timely reimbursement.
- Acquired appeal and peer-to-peer review information for communication with healthcare provider upon claim denial.
- Coordinated training for office staff on completing prior authorization forms and appeals, improving success rates for approvals.
- Maintained accurate records of benefits in EMR to streamline patient care processes.
- Registered patients in commercial copay assistance programs.
- Transmitted benefit documentation and copay approval documents to providers.
Reimbursement Specialist
RemX
11.2021 - 02.2023
- Contacted insurance carriers to verify patients' medical benefits for specialty medications, ensuring accurate claims processing.
- Coordinated with insurance providers to verify customers' policy benefits in relation to claims.
- Gathered appeal and peer-to-peer review information to inform healthcare providers on claim denials, facilitating timely resolutions.
- Trained office staff on completing prior authorization forms and appeals documentation, improving submission accuracy and success rates.
- Recorded patient benefits into EMR system for accurate tracking.
Patient Accounts Rep
Manpower Group
06.2020 - 04.2021
- Collected active pharmacy and medical insurance information from patients and physician offices to streamline billing processes.
- Processed pharmacy claim to determine eligibility for medication coverage through pharmacy benefit.
- Processed debtor payments and updated accounts to accurately reflect current balances for improved financial tracking.
- Enhanced customer satisfaction ratings by delivering proactive and actionable resolutions to inquiries, concerns, or challenges.
- Developed and implemented strategies to enhance customer retention and loyalty, fostering long-term relationships with patients.
Radiology Clerk
Montefiore Mt. Vernon Hospital
09.2017 - 04.2020
- Educated patients regarding procedure elements, supplied instructions, and clarified doubts to alleviate anxiety and boost cooperation.
- Streamlined office logistics by organizing appointments, managing files, and processing payments to support efficient operations.
- Responded to telephone inquiries, providing accurate office information and addressing questions to enhance patient experience.
- Administered private and confidential information following hospital standards and guidelines to ensure patient trust and compliance.
Education
Associate of Arts - Sociology
Maryville University Online
Missouri05-2026
High School Diploma - Foreign Languages
Foreign Language Academy of Global Studies
New York06-2008
Skills
- HIPAA compliance
- Medical Billing
- Database management and maintenance
- Project coordination
- Customer management
- Retention strategies
- Microsoft Office
- Prior authorization processing
Languages
Spanish
Limited
French
Limited
Certification
- Driver's License, State of North Carolina
Timeline
Reimbursement Specialist
Cornerstone Staffing LLC
05.2023 - 02.2024
Reimbursement Specialist
RemX
11.2021 - 02.2023
Patient Accounts Rep
Manpower Group
06.2020 - 04.2021
Radiology Clerk
Montefiore Mt. Vernon Hospital
09.2017 - 04.2020
Associate of Arts - Sociology
Maryville University Online
High School Diploma - Foreign Languages
Foreign Language Academy of Global Studies