Tonya Hemby

Work History

Guest Service Representative Flexi/PRN

Sentara Obici Hospital ER

12.2023 - Current

Responded to general inquiries from patients, visitors and family member.
Self-motivated, with a strong sense of personal responsibility.
Assisted in emergency situations as required while adhering strictly to safety protocols.
Maintained accurate and up-to-date records of guest information.
Maintained desk's fastpass book to provide visitors with access to relevant information.
Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
Contributed positively towards creating a welcoming atmosphere by maintaining a clean and organized front desk area at all times.

Patient Services Coordinator- Remote

Sentara Health Plans VPBH

05.2023 - 12.2023

Receiving calls from patients and discussing symptoms and /or medications to provide guidance if they need
Advising patients in community health plans on whether they need to ask about escalating treatment for a condition based on their symptoms and response to any existing treatment plans
Coordinating with hospital staff/ CCS/MLTSS case managers regarding member care and/or needs
Demonstrated exceptional customer service to foster welcoming and professional environment for patients.
Ensured timely and accurate completion of all required documentation for regulatory compliance, contributing to the overall quality of patient care services provided by the clinic.
Delivered support to medical staff in completion of patient paperwork.
Respected patients by recognizing rights and maintaining confidentiality.
Checking on the insurance coverage for patients and helping them to find solutions within their coverage when possible for AAP (Atypical Antipsychotic Program).

Director of Human Resources / BOM (6 Month Temp)

Accordious Healthcare Of Elizabeth City

Elizabeth City, NC

2022.11 - 2023.04

Assist resident, family and applicable outside agencies with Medicaid Pending applications to finalize facility coverage through Medicaid.
Experienced utilizing Point Click Care (PCC) billing system and Financial Management System (RFMS).
Experienced in performing healthcare reports, credentialing, compliance, risk analysis, auditing, project management, government and provider contracts negotiation tasks.
Responsible for RFMS for long term care residents, including weekly and monthly reconciliations.
Collaborated on hiring and EEO training of new employees and /or current employees.
Utilized compliance tools, corrective actions and identification of deficiencies to mitigate audit risks.
Conduct employee relations, compiling reports, grievances and investigations.
Enhanced team workflows and employee job satisfaction by coordinating communication between managers and employees.
Evaluated human resources structure and plan for continual improvement and offered individuals professional and personal growth opportunities.
Experience using one or more Human Resources Information Systems (HRIS) tracking system.
Knowledgeable of ADA (Americans with Disabilities Act) and Reasonable Accommodation along with skilled experience.
Interviewed potential hires, negotiated salaries and benefits and performed reference/ background checks.
Proved successful working within tight deadlines and a fast-paced environment.

Patient Access Rep1/ Human Resources Rep1

Sentara Healthcare Obici Hospital

Suffolk , VA

2020.02 - 2022.12

Assisting with audits, compliance reviews, and other mandatory reports.
Conducted workplace compliance training to reduce liability risks and operate effectively.
Entering tickets in Service now as well as train leaders and /or employees how to utilize Service Now.
Surgery scheduling, referrals and authorization.
Partnered with senior leadership to establish and develop corporate and HR policies and procedures.
Data entry of all new /returning nursing students.
Assisted employees in resolving conflicts through mediation services, leading to improved working relationships among team members.
Creating and maintaining accurate employee records and gathering all related documentation and key details in Workday.
Developed and implemented onboarding and orientation programs for new employees.
Provided exceptional customer service while guiding patients through complex insurance plans and payment options.
Answering employee questions regarding benefits and compensation options and assisting the administration of benefits
Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
Register/confirm outpatient scheduled procedures and appointments
Collect pertinent data such as patient demographics, medical and insurance verification via RTE in Epic Prelude.
Performed patient scheduling and registration functions to serve as initial contact point for medical visits.
Obtain patient/ family member signatures for Medicare forms (MOON, IMM's).
Effective handoff to other members of the team of end of shift report, patient/staff concerns, etc.
Perform peer to peer coaching with coworkers and patients informing them of Sentara promise by using Acknowledge, Introduce, Duration, Explanation and Thank you(AIDET).
Report incidents and patients concerns utilizing STARS reporting system and Workday.
Addressed bad debts in line with set protocols.
Assist patients and family members with questions, concerns, and issues regarding hospital/ departmental policy and procedures.
Conducted thorough pre-registration processes to verify demographic data, ensuring accuracy in financial systems and EHRs.
Enhanced hospital revenue by accurately verifying insurance information and collecting payments for services rendered.
Participated in ongoing professional development opportunities to stay current with industry trends and best practices in patient access services.

CEO/Human Resource /Manager of Operations

Time Management Services/Prominent Associates LLC

Chesapeake, VA

2009.06 - 2018.01

Addressed employee and managerial concerns and implemented corrective actions to promote compliance.
Founded performance- and merit-based evaluation system to assess staff performance.
Revenue Cycle Management-Month-end closing, Root cause analytics.
Analyzed industry trends and tracked competitor activities to inform decision making.
Special PMS platforms and implementation ie: Epic Prelude, QNXT, Athena and eclinical
Personnel development; staff retention, staffing, problem solving
Staffing discussions and planning/interviews; Team building
Procured and coordinated new resources to achieve sales targets within optimal timeframes.
Leadership of staffing of 26 employees
Remote projects management/ supervisor
Strong analytical reporting as well as reimbursement guidelines knowledge of Managed Care and Commercial payers.
Knowledge and experience in MCR/MCD reimbursement guidelines.
Negotiated contract terms of business acquisitions to increase business base and solidify market presence.
Provider credentialing CAQH, CACTUS, NCQA
Supported and coordinated clinic revenue cycle functions that include charge capture, coding, and edit/denial management, Project management.
Provided recommendations to optimize resources and aligning them with KPI performance metrics in specific categories of revenue cycle (productivity, compliance, accuracy, effectiveness, timeliness, and efficiency).
Coordinated and align the resources deployed to revenue cycle functions across the clinical specialty in an effort to build consistency of work flow and optimize resource usage.
Conducted internal audits to identify areas for improvement in HR policies, practices, and compliance measures.
Work with external medical office managers to formulate a plan for professional development, budgeting, and fee schedules.
Supervise daily revenue cycle operations in assigned clinical specialty and monitors revenue cycle metrics for area of responsibility.
Created a positive work culture, resulting in increased employee satisfaction and retention rates.
Supervise/Train staff as appropriate on revenue cycle activities, coding, billing and reimbursement practices.
Built productive relationships with industry partners and competitors to support strategic business objectives.

Summary

Overview

Work History

Guest Service Representative Flexi/PRN

Patient Services Coordinator- Remote

Director of Human Resources / BOM (6 Month Temp)

Patient Access Rep1/ Human Resources Rep1

CEO/Human Resource /Manager of Operations

Education

Bachelor of Arts - Business Administration And Management

High School Diploma in General Studies -

Skills

Certification

Additional Information

Personal Information

Groups

Timeline

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