Ivory Solomon
Seattle,WA
Summary
Astute medical professional trained in referral management, appointments, office management and recordkeeping. Helps staff maintain office operations at optimal levels with great organizational and multitasking abilities. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
12
12
years of professional experience
Work History
Referral Specialist (Remote)
Advantage Surgical & Wound Care
03.2021 - Current
- Assist team of wound and surgical specialists, managing authorizations, requests for various surgical procedures, and DME supplies.
- Manage all supply authorizations for wound specialists and their patients (which entail following up with various insurance plans, ensuring we have the correct ICD-10, CPT/HCPC codes for billing, and verifying insurance).
- Extremely well-versed in various insurance plans (Medicare, State Medicaid, Commercial, and Managed Care Plans), as well as medical terminology.
- Head of the Morale committee, which entails planning events for our 'Healthy Works Initiative,' staff holiday events, and employee recognition/appreciation.
- Maintain accurate records on in-progress and completed referrals, ensuring full data integrity throughout the process.
- Liaise with healthcare facility personnel, insurance representatives, physicians, and vendors for smooth communication, from intake to discharge.
- Coordinate with medical staff and patients to find cost-effective options for services.
Customer Advocate/Authorization Specialist
Biohorizon
10.2020 - 03.2021
- Advocated for patients who are in need of specialized wound/burn and compression garments (DME)
- Reviewed claims for inconsistencies and errors prior to being reconciled.
- Ensured all aspects of customer service are streamlined and assisted with creating training documents for our intake and customer service team which are now being used to train new hires.
- Create and submit authorizations to insurance which include verifying specific CPT codes as well as ICD-10 and diagnosis codes.
- Explained eligibility requirements, application details, payment methods and applicants' legal rights during intake assessment.
- Enhanced office productivity by handling high volume of callers per day.
- Navigated extensive company knowledge base to obtain appropriate solutions for customer service issues.
- Resolved customer issues to enable mutually beneficial outcomes and encourage continued cooperation.
Authorization Specialist
Kaiser Permanente
02.2020 - 10.2020
- Collaborated with insurance companies and physician offices to obtain prior authorization approvals for patient treatment for complex illnesses.
- Worked directly with members from various lines of business, providing benefit quotes, reviewing medical claims, assisting with premium payments and anything account related.
- Educated members of benefit changes and contract specifications, assist members with changes through OEP and AEP.
- Reviewed P/A’s for criteria to determine if further medical review was necessary due to network status, forwarded to clinical review if necessary.
- Reviewed P/A’s for criteria to determine if further medical review was necessary due to network status, forwarded to clinical review if necessary
- Received stellar rave reviews from the Prior Authorization leadership team of KPWA.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals..
Executive Assistant
Cryout Organization
01.2017 - 12.2019
- Proven track record of accurately maintaining detailed records, generating reports, coordinating meetings, and multitasking within a fluid environment.
- Worked closely with director to create expressive outlets for students and artists that fit inline with the yearly vision for the company.
- Assisted in managing the yearly EP music project and ensured all artists were adhering to project deadlines.
- Coordinated and maintained records for staff with an understanding of company priorities.
- Managed directors schedule, which included booking travel, scheduling/coordination of events, completing expense reports for reimbursement.
- Screened calls and emails and responded accordingly to support executive correspondence.
- Updated spreadsheets and created presentations to support executives and boost team productivity.
Payroll Coordinator
DataSphere Technologies Inc.
10.2015 - 08.2016
- Communicated with the Human Resources Department to ensure the integrity of payroll data including data related to new hires, terminations, transfers and rate changes; make updates as necessary.
- Researched and resolved questions from managers and employees as they relate to processing of payroll information such as PTO, banking, garnishments, employment verifications, workers compensation, retroactive pay calculations, tax questions, and other changes.
- Utilized “ADP Workforce Now” and excel (pivot tables, and various formulas) to ensure accurate processing of bi-weekly payroll and commission pay for 200+ employees in accordance with FLSA and state laws.
- Offered payroll-related subject matter expertise to management and employees to resolve payroll discrepancies.
- Investigated payroll variances and employee claims to resolve discrepancies and balance financial records.
- Reconciled health care benefits, tax contributions and retirement accounts to facilitate large-scale account reconciliations.
- Worked closely with the HR Department with employee onboarding and delivered friendly assistance with new hires throughout the interviewing and hiring process.
Wound Care Coordinator
Byram Healthcare
03.2013 - 10.2015
- Consistently attended ongoing training to further understand and explain Medicare and Medicaid guidelines and educating patients and doctors offices of insurance regulations pertaining to wound care DME supplies.
- Worked well under pressure while achieving high levels of productivity, handling 700+ calls weekly and averaging 100+ calls daily in peak season all with a focus on the client.
- Maintained a relationship with our wound clinics, home healthcare agencies and various insurances on a day to day basis to ensure our patients were receiving the best level of care.
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
- Used consultative techniques to understand customer needs and make strategic referrals to business partners.
Education
Associate of Arts - Business Administration
Seattle Central Community College
Seattle, WA05.2010
High School Diploma -
Rainier Beach High School
Seattle, WA06.2008
Skills
- Proficient in all Microsoft Office applications
- Exemplary verbal and written communication
- Strong work ethic and dependable
- Excellent prioritization and time management skills
- Employment Recordkeeping
- Human Resources Management Systems
- New Hire Onboarding
- Leave of Absence Transitions
- Upbeat and Positive Personality
- HIPAA Regulations
- Medical Terminology knowledge
- Patient Scheduling
- Google Suite Proficiency
- Database Management
- Insurance Verification
- Pre-Authorizations
Timeline
Referral Specialist (Remote)
Advantage Surgical & Wound Care
03.2021 - Current
Customer Advocate/Authorization Specialist
Biohorizon
10.2020 - 03.2021
Authorization Specialist
Kaiser Permanente
02.2020 - 10.2020
Executive Assistant
Cryout Organization
01.2017 - 12.2019
Payroll Coordinator
DataSphere Technologies Inc.
10.2015 - 08.2016
Wound Care Coordinator
Byram Healthcare
03.2013 - 10.2015
Associate of Arts - Business Administration
Seattle Central Community College
High School Diploma -
Rainier Beach High School
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