Summary
Overview
Work History
Skills
Timeline
Generic

AISHA M. SOSTRE

Kissimmee

Summary

Professional with strong background in care coordination. Skilled in patient advocacy, healthcare planning, and resource management. Known for effective team collaboration and achieving measurable results. Adaptable to changing needs with robust communication and organizational skills. Reliable and focused on delivering high-quality care outcomes.

Overview

11
11
years of professional experience

Work History

Care Coordinator - Access Team (Remote)

Advent Health Well 65+
08.2021 - Current
  • Used company software and databases to maintain records of services performed and patient conditions.
  • Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
  • Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations.
  • Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
  • Enhanced patient care coordination by effectively managing schedules for multiple healthcare providers.

Customer Service Supervisor

Centene Corporate – Florida Bilingual Service Center
09.2018 - 07.2021
  • Analyze daily phone log and performance reports to identify and implement improvement opportunities helping increase overall productivity and effectiveness
  • Ensure the team meets its goals and objectives through performance management, coaching and supervising the daily functions of the provider and provider services staff
  • Develop, motivate, coach, and counsel personnel, and advise management of work-flow issues, trends while searching for feasible resolutions
  • Develop teaching aids such as demonstration models, multimedia visual aids, computer tutorials, and reference materials
  • Audit team results, identify gaps in training and implement improvements in training programs
  • Served as Training Coordinator for multiple new hire classes assisting with onboarding
  • Facilitating new hire training as a Subject Matter Expert
  • Coordinate with other company sites working on special projects such as team newsletter, ordering company merchandise, updating distribution lists, etc
  • Assist members with website resources, navigation and troubleshooting
  • Educate members regarding their insurance benefits, copays, deductibles and coinsurance
  • Answer questions regarding member invoices and claims and appropriately route to other departments for review specifically for Ambetter products

Client Care Specialist

Centene - Cenpatico Behavioral Health
03.2016 - 03.2018
  • Provide members with information regarding their benefits and how to contact and access providers
  • Coordinate with clinical staff regarding notifications of Inpatient admissions or any changes to the admission
  • Educate providers of member’s eligibility, benefits, prior authorization requirements and authorization status
  • Support providers with credentialing application web submission and inform them the status of the application
  • Document all members’ and providers’ issues and resolution in the computer systems
  • Facilitate new hire trainings using a train the trainer model maintaining records of training activities and employee progress
  • Review new training materials for gamification Reporting behavioral and learning trends noticed during training to upper management
  • Serve as a point of contact for new employees in team group chats
  • Assist with supervisory duties such as escalations, monitoring service levels in CMS Supervisor, and special projects

Clinical Customer Care Advisor (Registered Pharmacy Technician)

Walgreens Corp
11.2014 - 03.2016
  • Field calls and provide information to the appropriate departments while maintaining a high level of professionalism
  • Document and provide notification of any urgent orders, shipping and insurance related issues to the proper parties
  • Coordinate patient care by processing orders, communicating information regarding shipments, verifying patient information, and notifying pharmacists of issues or changes with patient requests
  • Directing patients through layout and identity verification process on pharmacy website

Customer Care Representative at Volkswagen Credit

Bridge Personnel
12.2013 - 07.2014
  • Provide concise, accurate and complete responses to all inquiries
  • Proactively provide information to assist in determining the appropriate course of action with all its viable solutions
  • Maintain comprehensive follow-up and process all customer requests within the predetermined timeframes to ensure customer satisfaction
  • Use discretionary decision making for payment arrangements, extension, deferrals and due date changes
  • Navigating customers through registration, layout and troubleshooting of the Consumer Internet

Skills

  • Behavioral Health, Medical and Pharmacy
  • Prior Authorization and Claims experience
  • “Train the Trainer” Onsite Trainer
  • Coaching and development
  • Project management
  • Process improvement
  • Gamification
  • Bilingual in English and Spanish
  • Highly proficient in Microsoft Office XP and2007
  • Proficient in IEX and CMS applications
  • Cisco and Avaya Phone Operating Systems
  • Knowledgeable in Medicare part B & D

Timeline

Care Coordinator - Access Team (Remote)

Advent Health Well 65+
08.2021 - Current

Customer Service Supervisor

Centene Corporate – Florida Bilingual Service Center
09.2018 - 07.2021

Client Care Specialist

Centene - Cenpatico Behavioral Health
03.2016 - 03.2018

Clinical Customer Care Advisor (Registered Pharmacy Technician)

Walgreens Corp
11.2014 - 03.2016

Customer Care Representative at Volkswagen Credit

Bridge Personnel
12.2013 - 07.2014

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AISHA M. SOSTRE