Alayah Soileau, MHA
Maurice,LA
Summary
Strategic leadership, performance management, and transformative coaching are three key skills used extensively to drive operations excellence within healthcare settings. Possess the keen ability to multi-task under tight deadlines and effectively juggle competing priorities, effectively promoting, and driving collaboration with internal team and external stakeholders.
Overview
7
7
years of professional experience
Work History
Healthcare Consultant
CorroHealth
Remote
01.2023 - Current
- Manage key provider relationships and is accountable for critical interface with providers and business staff.
- Review hospital claims, and research applicable documents (contracts, state and federal legislation, insurance payer policies, medical records, etc.) to determine if the claim is underpaid.
- Escalate accounts to insurance provider relations for resolution and payment, including corresponding appropriately with provider relations teams, tracking the progress of issues, and ensuring that deadlines are met.
- Successfully negotiate payer contract renewals to create increased revenue.
Reimbursement Analyst
Boston Scientific
Remote/Contract
07.2022 - 01.2023
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Resubmitted claims after editing or denial to achieve financial targets and metrics. Managed at least 6 to 7 calls per day and rebilled $100,000 per week.
- Contributed knowledge to help improve financial management, billing, and tracking systems.
- Coordinated with insurance providers to verify customers' policy benefits in relation to claims by writing and submitting appeal letters.
Managed Care Contracting Associate
LHC Group
02.2022 - 06.2022
- Primary resource for new acquisitions, provider concerns regarding contract language, policies, services, claims, compensation issues, and renewal of contracts.
- Participate in and facilitate, preparation, execution, negotiation, and administration of agreements, contracts, and credentialing support when needed.
- Worked collaboratively with administrative staff in negotiation, correspondence, documentation, and compliance checks for service contracts.
- Developed and followed processes to manage contracts and remain in compliance with company commitments and regulatory obligations.
- Assisted in identifying and recruiting potential providers and administrative staff.
Managed Care Payor Relations Liaison
LHC Group
03.2021 - 02.2022
- Create and maintain relationships between operations, clients, and payors related to contract performance.
- Handle routine communication with payors and identify payor changes that must be communicated to operations and revenue cycle.
- Maintain existing payor relationships on all contracts including handling of operating issues to patient and administration concerns while identifying root causes and process improvement initiatives.
- Work closely with operations to ensure a thorough understanding of contracts, those under negotiation, and support for optimizing payor relationships.
- Increased revenues and supported business goals by developing public relations strategies.
- Engaged in recruiting activities to support operational and administrative staffing needs.
Managed Care Payor and Systems Coordinator
LHC Group
11.2020 - 03.2021
- Collaborate and oversee processes with Supervisor and Director to implement new processes.
- Established and maintained effective communication with staff, physicians, and community organizations to promote high-quality patient care.
- Perform initial due diligence on commercial, Medicare and Medicare Advantage payor environments to assess operational and financial impacts of new acquisition.
- Participates in development of Department best practices. Assist supervisor to develop and implement procedures to facilitate efficient workflow within department.
- Compile information from various sources and prepare specialized reports; format reports according to department standards.
- Played a role in recruiting new staff and supporting team expansion efforts.
Client Care Manager
Leading Healthcare
05.2017 - 11.2020
- Recruit, supervise, train, evaluate, and provide direction to Caregivers regarding all aspects of client care
- Properly document all client communications, care plan or medical changes, visit notes, or incidents
- Comply with all program guidelines and meet requirements established by LDH, Medicaid, and LHCL
- Handle complaints, provided appropriate solutions and alternative within appropriate timeframes and followed up to achieve resolution
- Built client relationships by responding to inquires, identifying and assessing clients’ needs, resolving problems, and following up with potential and existing clients
- Educated and evaluated clinical and support staff regarding care quality management regulations and standards of care
- Actively involved in the recruitment process for direct support workers and other key positions.
Education
Master of Health Administration, MHA -
Louisiana State University At Shreveport
Shreveport, LA2022
Bachelor of Science - Healthcare Administration
McNeese State University
Lake Charles, LA2020
Skills
- Project Management
- Negotiation
- Confidentiality / Integrity
- Creative / Analytical Thinking
- Program / Project Management
- Time Management / Organization Skills
- Financial Skills
- Teaming / Collaboration
- Financial Transformation
- Data Analysis
- Stakeholder Coordination
- Healthcare Marketing
Timeline
Healthcare Consultant
CorroHealth
01.2023 - Current
Reimbursement Analyst
Boston Scientific
07.2022 - 01.2023
Managed Care Contracting Associate
LHC Group
02.2022 - 06.2022
Managed Care Payor Relations Liaison
LHC Group
03.2021 - 02.2022
Managed Care Payor and Systems Coordinator
LHC Group
11.2020 - 03.2021
Client Care Manager
Leading Healthcare
05.2017 - 11.2020
Master of Health Administration, MHA -
Louisiana State University At Shreveport
Bachelor of Science - Healthcare Administration
McNeese State University