Samantha Davis
Morehead City
Summary
Insurance Coordinator known for high productivity and ability to complete tasks swiftly while maintaining accuracy. Skilled in claim processing, insurance verification, and billing procedures. Excel at communication, problem-solving, and time management, ensuring smooth operations within the practice. Ready to leverage specialized skills to enhance office efficiency and patient satisfaction.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Dental Insurance Coordinator
Barrett Davis, Jr. DDS and Associates Family Dentistry
Morehead City
02.2022 - Current
- Managed all aspects of insurance coordination for a busy dental office, ensuring accurate and timely processing of claims
- Verified patient insurance coverage and eligibility, minimizing claim denials and maximizing reimbursement
- Maintained detailed records of insurance information, including policy numbers, coverage limits, and pre-authorization requirements
- Collaborated with dental providers to gather necessary documentation for claim submission, such as treatment plans and x-rays
- Submitted electronic claims through various insurance portals, consistently meeting deadlines for claim submission
- Followed up on outstanding claims to resolve any issues or discrepancies in a timely manner
- Effectively communicated with patients regarding their insurance benefits and financial responsibilities
- Assisted patients in understanding their insurance coverage limitations and helped them navigate the billing process
- Responded to patient inquiries about insurance claims status or billing concerns in a professional and courteous manner
- Coordinated with third-party payers to obtain pre-authorizations for complex procedures or treatments requiring prior approval
- Worked closely with the billing department to reconcile payments received from insurance companies against outstanding balances
- Identified trends in denied claims and implemented corrective actions to minimize future denials
- Developed strong relationships with insurance company representatives to facilitate efficient claim processing and resolution of issues
- Stayed updated on changes in dental coding guidelines, fee schedules, and reimbursement policies to ensure accurate claim submissions
- Collaborated with dentists and hygienists during treatment planning meetings to determine appropriate codes for procedures, resulting in more accurate claim submissions
- Developed and maintained a database of commonly used dental codes, facilitating quick and accurate claim submissions
- Assisted in the development of patient financial policies and procedures, ensuring compliance with insurance regulations and maximizing revenue collection
- Counseled patients on available payment options, such as financing plans or flexible spending accounts, increasing patient satisfaction and reducing accounts receivable balances
- Collaborated with dental providers to optimize treatment plans based on insurance coverage limitations, maximizing reimbursement while meeting patients' oral health needs
- Maintained confidentiality of patient information according to HIPAA guidelines and ensured compliance among front desk staff members through training programs
Medical Billing and Coding Specialist
Moore Orthopedics and Sports Medicine
Morehead City
09.2014 - 02.2022
- Submitted claims electronically to insurance companies, resulting in faster reimbursement turnaround time
- Reviewed and verified patient information for completeness and accuracy, ensuring compliance with HIPAA regulations
- Accurately assigned medical codes to patient records using ICD-10 and CPT coding systems
- Identified and resolved billing errors or discrepancies, reducing claim denials by XX%
- Collaborated with healthcare providers to obtain missing documentation necessary for accurate coding and billing
- Maintained up-to-date knowledge of coding guidelines, reimbursement policies, and industry changes
- Performed regular audits on coded records to ensure compliance with coding standards and guidelines
- Managed a high volume of medical records while maintaining strict confidentiality protocols
- Worked closely with physicians and other healthcare professionals to clarify diagnoses or procedures as needed
- Followed up on unpaid claims or denied reimbursements, resolving issues promptly to maximize revenue collection
- Implemented efficient processes for tracking outstanding balances from insurance companies or patients
- Ensured timely submission of clean claims by meeting daily productivity targets
- Collaborated with the finance department to reconcile accounts receivable reports on a monthly basis
- Reduced average days in accounts receivable by XX% through effective follow-up on unpaid claims
- Resolved complex billing inquiries from patients, insurance companies, or third-party payers
- Maintained accurate documentation of all interactions related to billing inquiries or disputes
- Audited medical charts for proper documentation supporting billed services according to payer requirements
- Identified opportunities for revenue enhancement through proper coding and documentation practices
- Collaborated with physicians to ensure accurate capture of diagnoses and procedures performed
Radiology Department Front Desk Secretary
Carteret General Hospital/Radiology Department
Morehead City
04.2008 - 04.2014
- Acts as receptionist to outpatients and physicians coming into the department
- Relieves the radiology technologists of such clerical duties as typing forms, filing, long daily patient work, mailing of reports and dispositions of films when required by physicians or insurance companies
- Greets outpatients, and gives patients the proper outpatient examination 'prep forms'
- Participates in Performance Improvement activities
- Answers the phone properly and courteously in promoting good public relations between patients, physician, physician's offices and the hospital
- Scheduling of patients and making sure proper insurance is covered to meet medical necessity
- Making sure ICD-9 codes meet proper study being ordered per medical insurance
- Printing reports and making CD's for the floors, Medical Records, physicians and patients per request
Education
Certificate - Certified Professional Coding Curriculum
AAPC
Charleston, SC09.2023
Certificate - Medical Billing and Coding
Carteret Community College
Morehead City, NC04.2020
Certificate - Medical Office Clerk
Carteret Community College
Morehead City, NC08.2005
Certificate - Medical Terminology 1 & 2
Carteret Community College
Morehead City, NC08.2005
High school diploma or GED -
West Carteret High School
Morehead City, NC06.1999
Skills
- Medical Insurance
- Phone Etiquette
- Medical Coding
- ICD-10
- Medical Scheduling
- ICD-9
- Insurance Verification
- ICD Coding
- Transcription
- QuickBooks
- HIPAA
- Medical Office Experience
- Medical Records
- Medical Billing
- EMR Systems
- Medical Terminology
- CPT Coding
- Athenahealth
- DME
- Quality Assurance
- Anatomy Knowledge
- Data Entry
Certification
Professional Medical Coding Certification, 01/01/20, 05/01/20, The Professional Medical Coding certification has made me more aware of the CPT and ICD-10 books needed to provide proper codes for referrals, surgical procedures, physical therapy and diagnosis needed with the proper modifiers needed.
Additional Information
I have worked in the medical field front desk atmosphere for over 20 years. I am familiar with patient confidentiality and the HIPAA Laws regarding patient privacy. I am always eager to update and learn more knowledge to progress in the Medical field. I have taken many different medical courses and have been on medical billing and insurance claims within the last 6 years. I am familiar with the ICD-10 coding book; this book is used daily with my current job. I am also familiar with Meditech, Athena and Pacs system.
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Dental Insurance Coordinator
Barrett Davis, Jr. DDS and Associates Family Dentistry
02.2022 - Current
Medical Billing and Coding Specialist
Moore Orthopedics and Sports Medicine
09.2014 - 02.2022
Radiology Department Front Desk Secretary
Carteret General Hospital/Radiology Department
04.2008 - 04.2014
Certificate - Certified Professional Coding Curriculum
AAPC
Certificate - Medical Billing and Coding
Carteret Community College
Certificate - Medical Office Clerk
Carteret Community College
Certificate - Medical Terminology 1 & 2
Carteret Community College
High school diploma or GED -
West Carteret High School