Shierley Roby

• Supervised daily operations to ensure efficient departmental workflow.
• Trained staff on best practices and organizational policies.
• Coordinated schedules and assignments for team members effectively.
• Implemented process improvements to enhance service delivery standards.
• Facilitated communication between departments to streamline operations.
• Monitored compliance with healthcare regulations and safety protocols diligently.
• Ensured compliance with all safety regulations across the department.
• Resolved customer complaints in a timely manner.
• Addressed employee issues and conflicts to provide input, feedback, and coaching.
• Participated in weekly meetings with senior leadership teams to discuss progress.
• Conducted performance reviews for staff members.
• Provided coaching and mentoring support to team members.
• Delegated tasks appropriate to individual employees to provide development opportunities.
• Supervised departmental employees, delegating tasks and responsibilities.
• Established goals for each team member and monitored progress towards those objectives.
• Oversaw the hiring process, including recruiting, interviewing, and onboarding new employees.
• Organized and completed weekly schedules to ensure each shift was adequately covered.
• Coordinated cross-departmental initiatives to improve overall business performance.
• Fostered a positive and inclusive work environment, promoting teamwork and collaboration.

• Support physician and nurses by direct involvement in daily tasks.
• Assist patients with appointment scheduling or by serving as a liaison between patient and/or other medical departments.
• Works through and solves patient issues professionally and in a timely manner.
• Relayed phone messages clearly and concisely while assisting with calendar management, meeting coordination, and travel arrangements.
• Ensure all patients are rescheduled relating to physician out days in a timely manner.
• Order office supplies using cost-effective, appropriate cost center numbers and correct processes.
• Verify and update patient demographics and insurance information.
• Identify whether the patient needs referral and/or authorization and obtains referral and/or authorization when necessary.
• Ensures appointments are booked on properly, otherwise make different arrangements for the patient.
• Obtains proper information such as PCP, referring physician, CPT/DX codes prior to entering request into referral module.
• Input reasons for all visits on all appointments. Ensures same day add-on appointment is communicated to appropriate department personnel. Ensures authorization is secured for same day add-on appointment and same day inpatient hospital admissions.
• Assisted other departments within the pod by providing support and resources.
• Always maintains complete and up-to-date documentation and files, including product and service quotes.
• Prepare training manual for the department.
• Onboarded and trained new hires.
• Managed supply inventory and procurement processes.
• Work as a department lead seeing multiple complex issues in high stress environment

· Verify the patient order information on the type of equipment required.

· Insurance verification, collect copay and attach to the order.

· Review Medicare and Medicaid guidelines and apply criteria and make determination if the patient meets criteria for requested item.

· Follow up on all orders and making ensure that orders are submitted within the priority as required basedd on the Medicare and Medicaid turnaround time.

· Review contracts for fee schedule and guidelines as to how the HCPC code is covered (CAP/FFS or None covered item).

· Prepare an authorization request form and medical records to submit to the health plan for review, advising the plan as to the HCPC and diagnosis code

· Provide a determination as to the reason the patient does or does not meet criteria for the requested item based on Medicare/Medicaid guidelines.

· Coordinate deliveries with patient once request has been approved by health plan.

· Keep communication daily with the health plans on pending orders.

· Create excel spreadsheet of all pending orders and the status.

· Coordinate meetings with staff weekly and discuss any issues, concerns, and upcoming trainings.

· Update process and protocols as requested by management.

· Review the representative accounts daily and confirm all pending orders have been submitted in a timely manner.

· Problem solves on any issues that might arise with a patient or health plan concern.

· Maintain productivity up and assist the representatives as required.

· Coordinate meetings with health plans to discuss any pending issues and provide resolutions.

· Meet with management and provide resolutions on any outstanding orders.

· Training on new contracts and Medicare/Medicaid guidelines.

· Training new employees on process and protocols for the department.