LADONNA TOLSTON
Chicago,IL
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Customer Service Representative
BC FORWARD For ACCENTURE
Chicago
09.2023 - Current
- Demonstrated a high level of professionalism and attention to detail in all aspects of insurance verification specialist role, consistently exceeding performance expectations, managing a minimum of 35 cases per day while also maintaining an 98%+ accuracy rating.
- Proficient in projects such as EOB, OMNI, Medicare/Marx, CAQH/Ambetter TPL MOD/OHI, UAT Testing/TPL-In-A-Box
- Played key role in minimizing financial losses by identifying and correcting discrepancies in insurance information, meticulously verifying details, leading to reduction in claim denials.
- Maintained up-to-date knowledge of insurance policies and changes, aiding in accurate verification.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Enhanced user experience through thorough UAT testing for web applications, with focus on documenting defects, identifying bottlenecks and executing test cases.
- Recommended changes and corrections to developers for optimal software performance and usability.
- Led efforts in analysis and design of more cost-effective processing technology to improve current TPL manufacturing systems.
- Managed project timelines effectively, ensuring timely completion of critical process improvements without sacrificing quality or scope.
- Enhanced communication and collaboration between departments, ensuring a cohesive approach to process improvement efforts.
HOUSING SPECIALIST III
NAN MCKAY & ASSOCIATES
Chicago
12.2016 - 07.2022
- Direct client services with emphasis on reducing dependency on public assistance
and increasing client self-sufficiency - Assisted clients in understanding their rights and responsibilities as tenants, promoting healthy landlord-tenant relationships.
- Explained rental and housing regulations to clients and helped each discover best options for housing.
- Reviewed documentation and input data into computer system to complete eligibility process, re-certifications and tenant move-outs.
- Conduct eligibility reviews, income verification, rent calculations, and re-certifications.
- Provide case management and counseling to tenants, assisting with housing stability, lease compliance, and supportive services.
- Manage a monthly caseload 45-60 HCV/Section 8 participants.
- Evaluated rental applications thoroughly, verifying income eligibility and background checks for potential tenants.
- Maintain accurate records, prepare reports, and support audits/quality assurance.
- Train, mentor, and provide technical guidance to junior Housing Specialists.
- Researched possible fraud cases by scrutinizing bank statements and reconciling statements with reported income sources.
- Coordinated eviction prevention efforts by mediating disputes between landlords and tenants, ultimately preserving stable housing situations for at-risk individuals.
- Conduct participant voucher issuance
- Generate and execute HAP contracts.
- Direct client services with emphasis on reducing dependency on public assistance
and increasing client self-sufficiency - Performed Quality Control reviews on participant files to ensure compliance with federal and state housing regulations.
- Maintain accurate and complete electronic records within agency approved CRM software (i.e Salesforce
LEAD PATIENT ACCESS REPRESENTATIVE
Midwest Orthopaedics at Rush
Chicago, IL
09.2001 - 11.2016
- Greeted and assisted patients with check-in procedures.
- Improved revenue cycle management by verifying insurance eligibility and obtaining necessary authorizations.
- Accurately enter patient information into the appropriate EMR software.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Contributed to the successful launch of a new clinic location by assisting with staff training, process development, and workflow optimization efforts.
- Trained and mentored junior Patient Access Representatives, providing guidance and support for their professional development.
- Served as a liaison between patients, providers, and administrative staff to ensure seamless coordination of care across multiple departments.
- Answered incoming calls, scheduled appointments and filed medical records.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Worked with patients to ascertain issues and make referrals to appropriate specialists.
- Supported the implementation of new EMR software, facilitating a smooth transition for staff and patients alike.
- Partnered with quality assurance teams in conducting ongoing evaluations of the Patient Access department''s performance, leading to continuous improvements in service delivery.
- Maintained strict adherence to HIPAA regulations, protecting sensitive patient information from unauthorized access or disclosure.
Case Manager
Habilitative Systems, Inc
Chicago, IL
08.2001 - 09.2005
- Delivered case management services to families assigned by the Illinois Department of Children and Family Services
- Performed thorough intake assessments of clients' situations, identifying issues, goals and necessary intervention.
- Developed and implemented comprehensive case management plans to address client needs and goals in accordance with Agency requirements.
- Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies.
- Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources.
- Performed routine and impromptu home visits to ensure child safety and Agency compliance.
- Assisted families with the completion and submission of request for Foster Care
License approval/renewal - Scheduled and directed Agency required parental training classes
- Administered subsidy vouchers according to program requirements
- Attended court hearings to present findings of agency compliance and child placement recommendations
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Participated in community events to promote services and engage with public.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
- Managed crisis situations with empathy and professionalism, ensuring client safety and continuity of care.
- Developed resource directory for clients, simplifying their search for essential services.
Education
Bachelor of Science - Psychology
Southern Illinois University, Carbondale
Carbondale, IL05-2001
Skills
- Customer service
- Critical thinking
- Data entry
- Problem resolution
- Computer proficiency
- Payment processing
- Appointment scheduling
- Documentation
- Microsoft Office Suite
- Staff training
- Quality Assurance Review
- CRM software proficiency (Salesforce, Sharepoint, Yardi Voyager)
- Consistently meets or exceeds performance metrics with a 98% accuracy rate
Certification
- Certified Housing Choice Voucher Specialist, Nan McKay & Associates - 2017-Present
Timeline
Customer Service Representative
BC FORWARD For ACCENTURE
09.2023 - Current
HOUSING SPECIALIST III
NAN MCKAY & ASSOCIATES
12.2016 - 07.2022
LEAD PATIENT ACCESS REPRESENTATIVE
Midwest Orthopaedics at Rush
09.2001 - 11.2016
Case Manager
Habilitative Systems, Inc
08.2001 - 09.2005
Bachelor of Science - Psychology
Southern Illinois University, Carbondale