Sivornne Mony
Lowell,MA
Summary
Detail-oriented healthcare and customer support professional with experience in insurance reimbursement, patient coordination, and case support. Proven ability to navigate complex insurance processes, resolve escalations, and collaborate cross-functionally to improve patient outcomes and operational efficiency. Strong communicator with a background in nutritional science and a commitment to patient-centered care.
Overview
2027
2027
years of professional experience
1
1
Certification
Work History
Associate Case Manager
Alnylam Pharmaceuticals
Cambridge, MA
01.2022 - Current
- Perform comprehensive insurance verification and benefits investigations to determine patient eligibility, coverage details, and out-of-pocket responsibilities.
- Coordinate prior authorization follow ups and status checks across multiple insurance plans, including commercial and government payers to secure treatment approval and reduce delays in care.
- Pursued continuous medical education opportunities and attended relevant conferences to enhance knowledge of disease, reimbursement and insurance coverage.
- Serve as a key liaison between providers, pharmacies, patients, and insurance carriers to support seamless communication and case progression.
- Identify and escalate any coverage or reimbursement challenges, contributing to timely resolution to improve patient outcome.
- Validated treatment compliance through patient engagement and cross-functional team collaboration
- Assisted with new hire training, raising team's overall competency and service delivery standards.
Customer Care & Reimbursement Specialist
Insulet Corp
Acton, MA
01.2019 - 01.2022
- Streamlined reimbursement processes and insurance verifications for medical devices, minimizing delays and enhancing treatment continuity.
- Provided comprehensive information regarding insurance coverage options and available financial resources (when applicable) to patients
- Handle escalated cases by identifying issues, coordinating with internal teams, and delivering effective resolutions.
- Contribute to process improvements by identifying recurring issues and recommending workflow enhancements.
- Requested and collected relevant documentation, prior authorizations, order entry and coordinating shipment of product to customers
Patient Care Assistant
Northeast Arc
Danvers, MA
01.2013 - 2019
- Provided direct care and daily living support for individuals with disabilities and medical needs while implementing measures to reduce hospitalizations and enhancing patient care
- Monitored and documented patient progress, reporting changes to appropriate medical contacts.
- Served as a key point of contact for patient-related concerns and care coordination.
Administrative Assistant
Home Away From Home
Lowell, MA
2013 - 2015
- Managed daily office operations and routine clerical tasks to ensure efficient workflow and communication.
- Assisted and organized appointments, scheduling and transportation for clients
- Handled and submitted accounting documentation, insurance claim forms and medical records
- Provided exceptional customer service, addressing inquiries and resolving issues promptly.
- Attended client appointments providing translation services, ensuring medical understanding and advocacy
Education
B.S. - Nutritional Science
University of Massachusetts
Lowell, MA05.2018
Skills
- Patient coordination & support
- Microsoft Office (Word, Excel, Outlook, PowerPoint)
- Bilingual
- Documentation proficiency
- HIPAA Compliance
- Cross functional collaboration
Certification
Prior Authorization Certified Specialist Program (PACS) April 2024
Languages
English
Cambodian
Timeline
Associate Case Manager
Alnylam Pharmaceuticals
01.2022 - Current
Customer Care & Reimbursement Specialist
Insulet Corp
01.2019 - 01.2022
Patient Care Assistant
Northeast Arc
01.2013 - 2019
Administrative Assistant
Home Away From Home
2013 - 2015
B.S. - Nutritional Science
University of Massachusetts