Summary
Overview
Work History
Education
Skills
Personal Information
Timeline
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Samantha Francesca Martillo

Samantha Francesca Martillo

Health Care Coordinator
San Jose del Monte, Province of Bulacan

Summary

With two years of experience in healthcare, I am eager to apply my skills in case management, prior authorization, and eligibility verification etc. Dedicated to ongoing learning and advancement, I am committed to contributing to team success and fostering mutual growth and achievement. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

2
2
years of professional experience

Work History

Home Health Medicare Intake Coordinator

Brightstar Home Care
06.2024 - Current
  • Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
  • Maintained accurate and up-to-date client records.
  • Enhanced office productivity by handling high volume of callers per day.
  • Supported office staff and operational requirements with administrative tasks.
  • Answered phone calls and provided new clients with required paperwork to initiate service.
  • Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
  • Communicated with referral sources, physicians, and associated staff to check documentation for proper signatures.
  • Collaborated with administrative staff to manage appointment schedules effectively, reducing wait times and optimizing resource use.

Case Manager

12.2023 - Current
  • Reviewing medical documentation and treatment plans to determine the need for prior authorization
  • Communicating with healthcare providers to obtain necessary information and documentation for authorization requests
  • Initiating prior authorization requests with insurance companies, following their specific guidelines and procedures
  • Verifying insurance coverage and benefits for patients, including eligibility and any pre-existing conditions
  • Educating patients on their insurance coverage and any out-of-pocket expenses associated with medical services
  • Maintaining accurate records of authorization requests, including tracking status updates and approvals
  • Staying updated on changes in insurance policies, regulations, and industry standards related to prior authorization and verification
  • Documentation and Record-keeping to avoid liability

Verification/Authorization Coordinator

BCBS Tennessee
11.2022 - 12.2023
  • Daily census management involves tracking patients for admissions, discharges, and payer changes to ensure accurate and up-to-date records
  • Requesting continued stay/authorization to Insurance via Fax, Email, and call
  • Gathering patient’s clinical information's by getting MD Orders, Progress notes, Vital signs, Labs, updated therapy visits, skilled nursing medications
  • Coordinate communication between healthcare providers to ensure continuity of care
  • Maintaining accurate records of authorization requests, including tracking status updates and approvals
  • Receiving and Issuing NOMNC’s/Denials with the help of case manager lead and Facility
  • Scheduling Peer to Peer with Facility MD and Insurance MD (for commercial denials) Documentation and Record-keeping to avoid liability Scheduling Peer to Peer for Facility MD and Insurance MD

Verification/Authorization Coordinator

United Health Care
4 2022 - 10.2022
  • Daily census management involves tracking patients for admissions, discharges, and payer changes to ensure accurate and up-to-date records
  • Requesting continued stay/authorization to Insurance via Fax, Email, and call
  • Gathering patient’s clinical information's by getting MD Orders, Progress notes, Vital signs, Labs, updated therapy visits, skilled nursing medications
  • Coordinate communication between healthcare providers to ensure continuity of care
  • Maintaining accurate records of authorization requests, including tracking status updates and approvals
  • Receiving and Issuing NOMNC’s/Denials with the help of case manager lead and Facility
  • Scheduling Peer to Peer with Facility MD and Insurance MD (for commercial denials) Documentation and Record-keeping to avoid liability Scheduling Peer to Peer for Facility MD and Insurance MD

Education

BS Nursing - 3rd yr Undergraduate, COLLEGE -

Our Lady of Fatima University

SHS Graduate, SENIOR HIGH SCHOOL - undefined

University of the East

Cainta Catholic College (2013-2015) Grade 8 and 9, Immaculate Heart of Mary (2006-2012) Grade 2-Grade 7, SECONDARY - undefined

Siena College of San Jose- (2015-2016) Grade 10

Skills

Knowledgeable with some Insurance Portals

Case Management

Communication Skills

Attention to Detail/Problem-Solving

Time Management

Excellent communication skills (written and verbal)

Knowledgeable in Microsoft tools

Willingness to Learn

Scheduling appointments

Follow-up skills

Appointment Scheduling

Insurance Verification

Patient Scheduling

Customer Service

Microsoft Office

Problem-Solving

Data Entry

Multitasking

Personal Information

  • Age: 25
  • Height: 5'2
  • Weight: 75Kg
  • Date of Birth: 02/26/99
  • Gender: Female
  • Marital Status: Single

Timeline

Home Health Medicare Intake Coordinator

Brightstar Home Care
06.2024 - Current

Case Manager

12.2023 - Current

Verification/Authorization Coordinator

BCBS Tennessee
11.2022 - 12.2023

Verification/Authorization Coordinator

United Health Care
4 2022 - 10.2022

BS Nursing - 3rd yr Undergraduate, COLLEGE -

Our Lady of Fatima University

SHS Graduate, SENIOR HIGH SCHOOL - undefined

University of the East

Cainta Catholic College (2013-2015) Grade 8 and 9, Immaculate Heart of Mary (2006-2012) Grade 2-Grade 7, SECONDARY - undefined

Siena College of San Jose- (2015-2016) Grade 10

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Samantha Francesca MartilloHealth Care Coordinator