Samina Blackmon
New Port Richey,FL
Summary
Tenacious Referral Specialist with 10 years connecting clients with medical providers. Successful working with insurance companies and other medical professionals to obtain prior authorization and set up essential client appointments. Applies proactive approach to problem-solving and resourceful use of industry network.
Overview
17
17
years of professional experience
Work History
Medical Referral Specialist III
Centene, Health Services
04.2013 - Current
- Schedule Peer to Peers for the Medical Directors
- Review and make any corrections to all denial letters rationale for Medical Directors.
- Collaborated with team members to create Step Actions and Job Aids for the MRC department.
- Respond to voicemails from hospitals and providers and enter peer to peer request into the Care Central database.
- Selected to Audit Medicaid Hawaii letters for Medical Directors; to ensure grade level verification of 6.9 readability.
- Upload and track peer to peer requests in the vendor database, Advance Medical Review(AMR).
Inpatient Care Coordnator
WellCare
04.2013 - 10.2022
- Entered confidential patient information and updated electronic records within database.
- Verify eligibility and benefits
- Answer inbound and outbound calls
- Responsible for obtaining discharge dates
- Assist nurses by creating new authorization for inpatient addition
- Assist with training new employee
- Creating new QIO appeals from phone queues processing faxes within timeframe
- incoming payments and document service issues.
Billing Processor
DPMG INC The Auto & Motorcycle Accident Injury
06.2012 - 12.2012
- Increased efficiency in billing processes by streamlining workflows and implementing new software tools.
- Reduced errors in invoicing by conducting thorough quality checks and maintaining accurate records.
- Enhanced customer satisfaction with prompt resolution of billing inquiries and disputes.
- Collaborated with the sales team to ensure accurate pricing information for quotes and contracts.
Package Handler
FedEx Ground
10.2010 - 01.2012
- Improved package handling efficiency by implementing proper sorting and organizing techniques.
- Reduced damage rates for packages through careful handling and adherence to safety protocols.
- Streamlined workflow by coordinating with team members on efficient loading and unloading procedures.
- Enhanced customer satisfaction by ensuring timely delivery of packages through efficient processing methods.
Mail Processor
US Post Office
03.2007 - 10.2009
- Improved mail processing efficiency by implementing an effective sorting system.
- Streamlined workflow for faster mail delivery by maintaining a clean and organized workstation.
- Reduced errors in mail handling with thorough attention to detail and accuracy in labeling packages.
- Enhanced customer satisfaction by ensuring timely delivery of priority mails through careful prioritization of tasks.
Education
Associate of Science - Medical Billing & Coding
Everest College
Tampa, FL01.2010
Skills
- Referral Coordination
- Decision Making
- Telephone Etiquette
- Electronic Health Records
Timeline
Medical Referral Specialist III
Centene, Health Services
04.2013 - Current
Inpatient Care Coordnator
WellCare
04.2013 - 10.2022
Billing Processor
DPMG INC The Auto & Motorcycle Accident Injury
06.2012 - 12.2012
Package Handler
FedEx Ground
10.2010 - 01.2012
Mail Processor
US Post Office
03.2007 - 10.2009
Associate of Science - Medical Billing & Coding
Everest College
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