Fatuma Fofana
Columbus,OH
Summary
Compassionate Patient Care Coordinator with understanding of hospital operations and patient care. Patient-focused professional equipped with administrative and customer service expertise. Helps keep healthcare services proceeding smoothly by coordinating communications, referrals, and policy enforcement. Experinced in finding balanced solutions and resolving conflicts. Excel in communication, problem-solving, and time management, ensuring successful project outcomes through effective leadership and teamwork. Strong background in coordinating between patients, healthcare professionals, and insurance companies to ensure seamless service. Skills include problem-solving abilities, communication skills, and empathy towards patients' needs. Possess specialized skills in conflict resolution, patient advocacy, and health information privacy practices.
Overview
9
9
years of professional experience
Work History
Waiver Coordinator
Astrya Corporation
Richmond, Virginia
05.2024 - Current
- Complete administrative waiver reviews for Indiana State Medicaid
- Ensure all fields within the form/application are complete such as matching required fields to key eligibility requirements to determine if application can be processed
- Routing reviews that are incomplete or missing key eligibility determination to medical team for review
- Responsible for completing waiver application review and routing to appropriate team for next step
- Meet internal and external timeliness criteria by completing reviews in a timely manner
- Maintain a high level of customer satisfaction with timely problem resolution
Customer Service Assistant 2 Intermittent
Ohio Department of Medicaid
Columbus, Ohio
01.2023 - 07.2023
- Reviews and responds to problem medical claims received from medical providers which were rejected for Medicaid payment or are unpaid
- Operates personal computer to access the Medicaid Information Technology System (MITS) to retrieve various subsystems (e.g., claims processing & procedures, drug and diagnosis to verify utilization criteria and code validity, recipient to verify consumer eligibility, prior authorization to verify approvals, denials and referrals)
- Refers to reference material to interpret Medicaid, waiver, and other medical assistance program policies, billing instructions and/or claim processing procedures to resolve provider inquiries/complaints; explains decisions made to providers
Care Coordinator
Puerto Rican Family Institute, Inc.
New York, NY
01.2020 - 01.2021
- Advocate and monitor for appropriate service delivery, including helping individuals make and keep appointments, escorting individuals to appointments as necessary, and assisting recipients in arranging needed mental and physical health and psychiatric rehabilitation services while adhering to the client’s rights
- Document and file all chart documentation including but not limited to progress notes, assessments, treatment plans, as well as weekly schedules and statistical reports in a timely fashion in accordance with NYSDOH, NYSOMH, OMIG, Health Home, and agency guidelines in the charts as well as the Health Home portals as required
- Provides Care Coordination services and maintains documentation requirements in compliance with NYSDOH, NYSOMH, OMIG, Health Home, and agency guidelines
- Clearly informs clients of goals, configuration, and function of the program
- Outreach, engage, and enroll the clients into the program to ensure their stability in the community
- Identify individuals appropriate for Health Home services and facilitate their enrollment process into the program
Intern- Language Bank Services
Bronx Lebanon Hospital
Bronx, NY
01.2018 - 04.2018
- Facilitated language interpretation services for patients at Bronx Lebanon Hospital in over 200 languages through phone/video call and scheduled in person American Sign Language for visually/hearing impaired
- Coordinated documents to get translated in top 5 languages of hospital as per request of Clinic Supervisors in desired language
- Routine check up on Bronx Lebanon clinics to ensure all interpretation phones are working and discard broken/malfunctioning phones
- Speak to medical staff and Supervisors for issues regarding interpretation services and provide solutions
- Completed projects assigned by Vice President of Quality Assurance
Field Staff Coordinator
A+ Care
Bronx, NY
01.2017 - 01.2018
- Manage daily scheduling of home care personnel and coordination of delivery of service between patient, employee and third party
- Develop techniques and methods for resolution of home care scheduling and assignment issues
- Review compliance statistics ensuring home care worker employment prerequisites are current and appropriate, prior to assigning cases
- Assign specialized Para-professional care givers to meet the specific needs of patients
- Schedule appropriate personnel according to referral information, under the direction of Nursing Supervisor and Office Manager
Intake Coordinator
VNSNY Hospice Care
New York, NY
10.2015 - 01.2017
- Received referrals and reviewed patient information to determine initial appropriateness of hospice care
- Promoted and fostered ongoing collaborative communication with institutional and VNSNY personnel to establish coordinated hospice care
- Facilitated safe and timely transfer of patients from hospital to home
- Arranged delivery of equipment to patient
- Provided constant communication between physicians to obtain verbal orders and request clinical information regarding patient diagnosis
- Entered patient information in EMRs, verified Medicaid and Medicare insurance information
- Contacted family members to retrieve consent and schedule visits according to their wishes and availability
- Set up resources for patients including translators, escorts, social workers, HHA’s and spiritual counselors
Education
Master of Public Health -
Monroe College
Bronx, NY08.2018
Bachelor of Science - Health Services Administration
CUNY Lehman College
Bronx, NY09.2015
Skills
Language
- Soninke
- Arabic (read and write)
Skills
- Task prioritization
- Schedule coordination
- Client coordination
- Customer service
- Adaptability and flexibility
- Team collaboration
- Medical billing
- Document management
Database Management Systems
- Microsoft Excel
- Microsoft Word
- Microsoft PowerPoint
- DataEase, People Soft, Sun Coast, Main Frame, MITS, BAHN
- Indiana State MMIS system
- Healthcare compliance
- Healthcare delivery systems management
- Public health
Timeline
Waiver Coordinator
Astrya Corporation
05.2024 - Current
Customer Service Assistant 2 Intermittent
Ohio Department of Medicaid
01.2023 - 07.2023
Care Coordinator
Puerto Rican Family Institute, Inc.
01.2020 - 01.2021
Intern- Language Bank Services
Bronx Lebanon Hospital
01.2018 - 04.2018
Field Staff Coordinator
A+ Care
01.2017 - 01.2018
Intake Coordinator
VNSNY Hospice Care
10.2015 - 01.2017
Master of Public Health -
Monroe College
Bachelor of Science - Health Services Administration
CUNY Lehman College
Similar Profiles
Janel BoragineJanel Boragine
Director of Human Resources and Credentialing at Astrya Global, IncDirector of Human Resources and Credentialing at Astrya Global, Inc
Rebecca BolnerRebecca Bolner
Coordinating Center Associate at United United BioSource Corporation CorporationCoordinating Center Associate at United United BioSource Corporation Corporation
Sandhya YSandhya Y
System Supervisor at Karnataka State Road Transport Corporation(KSRTC) & Bengaluru Metropolitan Transport CorporationSystem Supervisor at Karnataka State Road Transport Corporation(KSRTC) & Bengaluru Metropolitan Transport Corporation
Hunter KelloggHunter Kellogg
Lab Technician at Wexner Medical Center, The Ohio State UniversityLab Technician at Wexner Medical Center, The Ohio State University
Norman BarcusNorman Barcus
Lead Technician at PuroClean Restoration SpecialistsLead Technician at PuroClean Restoration Specialists