Ivory Solomon
Kent
Summary
Dynamic healthcare professional with extensive experience in prior authorization and referral management at Kinwell Health. Proven ability to build relationships and advocate for patients, achieving high satisfaction ratings through effective communication and critical thinking. Skilled in care coordination and strategic planning, ensuring seamless transitions and optimal patient outcomes.
Overview
13
13
years of professional experience
Work History
Referral Coordinator
Kinwell Health
Renton
03.2025 - Current
- Review patient records to determine appropriate referrals based on medical necessity, and insurance requirements.
- Manage patient referrals and facilitate care transitions, collaborating with providers to develop comprehensive plans and connect patients with necessary healthcare services.
- Collaborated with internal departments to ensure smooth transitions for referred patients.
- Conducted follow-up with patients and healthcare providers to ensure satisfaction and address any concerns post-referral.
- Coordinated with external agencies to ensure timely processing of referrals.
- Participated in regular meetings to discuss referral strategies, network expansion, and program performance metrics.
- Identified and resolved inconsistencies in patient responses by means of appropriate questioning or explanation.
- Communicate with patients, healthcare providers, and insurance companies to obtain the necessary information for referrals.
- Coordinate communication between primary care providers and specialists to facilitate continuity of care.
- Obtain prior authorizations from insurance companies for specialty procedures or treatments.
- Monitor referral trends and utilization patterns to identify opportunities for process improvement or cost-saving initiatives.
- Develop relationships with external healthcare providers and facilities to streamline the referral process and enhance collaboration across the continuum of care.
Referral Specialist (Remote)
Advantage Surgical & Wound Care
10.2020 - 04.2025
- Assisted a team of wound and surgical specialists, managing authorizations, requests for various surgical procedures, and DME supplies.
- Managed all supply authorizations for wound specialists and their patients, which entails following up with various insurance plans, ensuring we have the correct ICD-10, CPT/HCPCS 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 entailed planning events for our 'Healthy Works Initiative,' staff holiday events, and employee recognition/appreciation.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout the process.
- Liaised with healthcare facility personnel, insurance representatives, physicians, and vendors for smooth communication, from intake to discharge.
- Coordinated with medical staff and patients to find cost-effective options for services.
Patient Care Coordinator
Kaiser Permanente
02.2018 - 10.2020
- Collaborated with insurance companies and physician offices to obtain prior authorization approvals for patient treatment for complex illnesses.
- Coordinated patient care services for diverse medical equipment needs.
- Liaised effectively with patients, doctors and staff members, assessing medical charts and promoting high level of communication and interaction
- 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, and forwarded to clinical review if necessary.
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.
Patient 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 about 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 a 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
- Prior authorization and referral management
- Care coordination and patient advocacy
- Relationship building and empathy
- Cultural sensitivity and effective communication
- Strategic planning and goal setting
- Multitasking and attention to detail
- Customer relationship management
- Critical thinking and problem solving
Timeline
Referral Coordinator
Kinwell Health
03.2025 - Current
Referral Specialist (Remote)
Advantage Surgical & Wound Care
10.2020 - 04.2025
Patient Care Coordinator
Kaiser Permanente
02.2018 - 10.2020
Payroll Coordinator
DataSphere Technologies Inc.
10.2015 - 08.2016
Patient Care Coordinator
Byram Healthcare
03.2013 - 10.2015
Associate of Arts - Business Administration
Seattle Central Community College
High School Diploma -
Rainier Beach High School