Soninka Henry

Demonstrate accountability by adhering to established benchmarks such as meeting average caseloads, WorkIQ production targets (85%), production queue management. Adhere to use of all key operational support tools to drive adherence to established key performance indicators (KPI’s), productivity and operational efficiency. Demonstrate agility, accountability, and integrity by driving effective communication with departmental leads within the market. Demonstrate integrity by ensuring 100% compliance with all applicable clinical, quality, federal, state/contract and regulatory requirements to prevent sanctions and fines.

Measures:

• Ensure activity and documentation successfully passes all external quality review organization (EQRO) and/or National Committee for Quality Assurance (NCQA) audits in 2024 with a 100% pass rate.
• Demonstrate agility, accountability, and integrity by driving effective communication with departmental leads within the market.
• Participate in local plan-based meetings and Town Halls.
• Timely reporting of HIPAA violations in compliance with policies and procedures.
• Meet/Exceed state turnaround time (TAT) Targets.
• Timely facilitation of utilization management (UM) and case management (CM) case creation.
• Initiate daily case creation via inbound calls and inbound fax management per target minimum of 40-50 authorization cases per day to include P2P and MCMC. Maintain a 95% random quality audit score.
• Support healthcare management systems (HMS’s) clinical strategic approach and actively participate in the testing and process development of clinical initiatives.
• Demonstrate agility through active, connected engagement with Elevance Behavioral Health continue BH integration initiatives, and drive further efficiencies and whole person care.
• Actively participate in ongoing education and initiatives that facilitate member engagement and improve member outcomes.

Scheduled appointments at HCA, leveraging clinical data to secure pre-authorizations for insurance coverage. Coordinated patient appointments, verified authorizations, and communicated testing requisites to attending physicians' offices in accordance with instructions and queries generated from the Meditech scheduling module.

• Streamlined and organized scheduling process to enhance patient care coordination and reduce administrative delays.
• Managed multiple schedules and prioritized tasks to meet demands of fast-paced work environment.
• Processed payments and managed financial records to facilitate proper billing and tracking of payment history.
• Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy.
• Coordinated with other departments to facilitate seamless operation and excellent patient care.
• Followed up with patients to reschedule missed appointments.
• Collaborated with healthcare staff to verify alignment of appointment scheduling with clinic protocols.
• Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
• Completed administrative patient intakes with case histories, insurance information and mandated forms.

Responsible for concierge program with multiple medical offices for scheduling outpatient services. Conducted call center training sessions, delivered comprehensive instruction on customer service protocols and procedures while supervising 20 employees concurrently to ensure seamless workflow and achieve desired results. Engaged in interviewing and facilitating submission of hiring documents to HR. Oversaw team audits for both new hires and existing team members to ensure strict adherence to quality standards. Mentored team members to facilitate professional growth and success in roles while fostering a motivated and skilled workforce. Reviewed shared mailboxes, resolution of issues, preparation of monthly reports, and active participation in meetings.

• Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.
• Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
• Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
• Enforced rules and regulations outlined in company manual to set forth expectations comprehensibly and consistently.
• Achieved results by working with staff to meet established targets.
• Evaluated employee performance and coached and trained to improve weak areas.
• Created successful work schedules for each team member to maintain deadlines and fully staff shifts.
• Maintained compliance with company policies, objectives, and communication goals.
• Monitored workflow to improve employee time management and increase productivity.
• Boosted team performance by developing customer service training materials and conducting service training.
• Solicited customer feedback to identify and improve on areas of weakness.
• Developed and implemented customer service policies to enhance satisfaction.
• Generated reports detailing findings and recommendations.
• Cultivated positive relationships with vendors to deliver timely and cost-effective supply of services and materials.
• Developed effective improvement plans in alignment with goals and specifications.
• Optimized customer experience by delivering superior services and effectively troubleshooting issues.
• Created and managed project plans, timelines and budgets.
• Conducted routine inspections to check quality and compliance with established specifications.
• Maintained database systems to track and analyze operational data.
• Devised and implemented processes and procedures to streamline operations.
• Gathered, organized and input information into digital database.
• Educated staff on organizational mission and goals to help employees achieve success.
• Evaluated staff performance and provided coaching to address inefficiencies.
• Helped meet changing demands by recommending improvements to business systems or procedures.

Ensured accurate test sequencing, minimizing patient wait times for those undergoing multiple tests. Meticulously reviewed both Medicare and non-Medicare cases, upholding rigorous clinical and financial standards. Facilitated integration of intra-departmental functions by assessing scheduling prerequisites and constraints for each test procedure, aligning them with available physical resources such as equipment, staff, and room availability.

Streamlined add-on and same-day appointment coordination across diverse service areas aimed at maximizing workflow efficiency, resource utilization, and overall customer satisfaction.

• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Managed multiple schedules and prioritized tasks to meet demands of fast-paced work environment.
• Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
• Collaborated with healthcare staff to verify alignment of appointment scheduling with clinic protocols.
• Processed payments and managed financial records to facilitate proper billing and tracking of payment history.
• Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy.
• Managed complex calendars for multiple medical practitioners, verifying accuracy of all appointments.
• Developed and implemented efficient scheduling systems to maintain organized medical appointment schedules.
• Followed up with patients to reschedule missed appointments.
• Coordinated with other departments to facilitate seamless operation and excellent patient care.
• Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
• Placed new supply orders, managed inventory and restocked clerical spaces.
• Performed various administrative tasks by filing, copying and faxing documents.
• Organized and maintained patient chart filing system to promote quick data finding for staff.
• Assisted with medical coding and billing tasks.
• Obtained payments from patients and scanned identification and insurance cards.
• Processed medical insurance claims and payments.
• Greeted visitors and initiated triage processes for clients to streamline patient flow.