Toya Johnson
Houston,TX
Summary
Passion for helping others! Ready to be responsible for facilitating performance-based learning events focused primarily on concrete skills related to operations processes and onboarding and orientation training. Authorized to work in the US for any employer Work. Referral Specialist offering background coordinating and managing patient referral process. Gifted at obtaining required documentation, answering patient questions and communicating with insurance providers. Mastery of medical and insurance terminology and abbreviations.
Overview
12
12
years of professional experience
Work History
Referral Specialist II
Elevance
Houston, TX
09.2021 - Current
- Compiled, recorded, or coded data from referrals or surveys using computer or specified form.
- Identified potential problems with referrals before submitting them to insurers and worked with providers to resolve those issues quickly.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Processed incoming referral requests for medical services and submitted them to the appropriate insurance companies for authorization.
- Gathered and verified insurance requirements to meet payer requirements.
- Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
- Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
- Reviewed referral details and expectations with providers and patients and requested new referrals when necessary.
- Answered questions and resolved concerns raised by both patients and specialists.
- Provided support to referring physicians in obtaining pre-authorization for services as necessary.
- Communicated with patients with compassion while keeping medical information private.
- Verified insurance eligibility for referred services using online databases and contacted insurers directly when needed.
- Reviewed all documentation associated with each referral request to ensure compliance with relevant regulations.
- Assisted patients by answering questions and providing information regarding referrals.
- Developed productive working relationships with numerous insurance company representatives.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Entered confidential patient information and updated electronic records in database.
- Managed and obtained insurance authorizations for patient referrals from physicians.
- Assisted patients in understanding their insurance coverage and answered questions about referrals, authorizations, and other related issues.
- Obtained PA for services such as diagnostic imaging.
- Communicated regularly with referring physicians, nurses, case managers, social workers, and other healthcare professionals regarding referral processes and requirements.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Recognized by management for providing exceptional customer service.
- Identified needs of customers promptly and efficiently.
- Understood and followed oral and written directions.
- Maintained updated knowledge through continuing education and advanced training.
- Completed day-to-day duties accurately and efficiently.
- Worked with cross-functional teams to achieve goals.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Exceeded customer satisfaction by finding creative solutions to problems.
Health/Wellness Coach
Jenny Craig
Clear Lake, TX
06.2020 - 09.2021
- Assess the clients to get them the best program for weight loss needs and goals Coaching: Utilize the Jenny Craig Service Model to (1) connect with clients and understand their goals and challenges, (2) identify and keep them focused on their motivation, (3) create weekly plans, (4) build their confidence, and (5) gain their commitment
- Client Accountability: Keep clients on the Jenny Craig Program by holding them accountable to (1) their menu plan, (2) attending their coaching session every seven days, and (3) self-monitoring their daily food intake and exercise
- Complete care calls and confirmation calls to stay connected with clients throughout the week
- When clients fall off the Jenny Craig Program, get them back on Program by making outbound calls
- Center Operations: Complete daily center operations tasks including food room stocking and client invoicing and checkout
- Role Model: Be a role model to clients and employees by living the Jenny Craig principles of ideal weight and lifestyle.
Stylist Supervisor
Hair Club for Men and Women
11.2017 - 06.2020
- Develop, and provide training and staff development programs, using knowledge of the effectiveness of methods such as classroom training, demonstrations, on-the-job training, meetings, conferences, and workshops
- Conduct or arrange for ongoing technical training and personal development classes for staff members
- Confer with management and conduct surveys to identify training needs based on projected production processes, changes, and other factors
- Conduct orientation sessions and arrange on-the-job training for new hires
- Contact suppliers to verify shipment details
- Cut, trim and shape hair or hairpieces, based on customers' instructions, hair type and facial features, using clippers, scissors, trimmers, and razors
- Comb, brush, and spray hair or wigs to set style
- Calculate figures such as required amounts of labor and materials, manufacturing costs, and wages, using pricing schedules, adding machines, calculators, or computers
- Recommend and explain the use of cosmetics, lotions, and creams to soften and lubricate skin and enhance and restore natural appearance
- Keep workstations clean and sanitize tools such as scissors and combs
- Schedule client appointments
- Maintain files such as maintenance records, bills of lading, and cost reports
- Analyze patrons' hair and other physical features to determine and recommend beauty treatment or suggest hair styles
- Operate cash registers to receive payments from patrons
- Shave, trim and shape beards, and moustaches
- Arrange for delivery, assembly, and distribution of supplies and parts to expedite flow of materials and meet production schedules
- Develop new styles and techniques
- Update and maintain customer information records, such as beauty services provided
- Apply water, setting, straightening, or waving solutions to hair and use curlers, rollers, hot combs, and curling irons to press and curl hair
- Train or supervise other hairstylists, hairdressers, and assistants
- Establish and prepare product construction directions and locations, and information on required tools, materials, and equipment, numbers of workers needed, and cost projections
- Shampoo, rinse, condition and dry hair and scalp or hairpieces with water, liquid soap, or other solutions
- Requisition and maintain inventories of materials and supplies necessary to meet production demands
- Demonstrate and sell hair care products and cosmetics
- Shape eyebrows and remove facial hair, using depilatory cream, tweezers, electrolysis, or wax.
Patient Care Technician II
DaVita Inc.
Houston, TX
08.2012 - 03.2017
- Direct Patient Care
- Spent most of your day in direct one-on-one patient care to provide safe, comfortable, and hygienic dialysis treatment
- Cared for multiple patients
- Technician Duties: To monitor patients before, during and after dialysis treatment including measuring and recording stats, patient observations, and hemodialysis machine setup
- Please note you will have exposure to blood and needles
- Building long-term relationships with your patients who are suffering from end stage renal disease and are receiving treatment on average 3 times/week
- You will also be responsible for educating patients on Kidney Dialysis related topics
- Team
- Cross functional team of clinicians including technicians, nurses, dietitians, social workers and leadership
- PCTs work under the supervision of a RN.
Education
Vocational in General -
SMILEY HIGH SCHOOL
05.1999
Some College (No Degree) - Surgical Technology
NATIONAL INSTITUTION OF TECHNOLOGY
Some College (No Degree) - Teacher Education
UNIVERSITY OF PHOENIX
Skills
- Sales
- Hair Styling
- Aseptic Technique
- Medical Imaging
- Patient Care
- Experience Administering Injections
- Triage
- EMR Systems
- Phlebotomy
- Vital Signs
- Laboratory Experience
- Medical Terminology Knowledge
- Database Management
- Appointment Scheduling
- Google Suite Proficiency
- Accurate Documentation
- HIPAA Regulations
- Outbound Calls
Additional Information
Skilled in Microsoft Office (Word, Excel, PowerPoint). Proficient in, at a minimum, of one Post Acute Solutions intake process. Proficiency in one or more of the following PAS processes: Post Acute Care Medicare, Post Acute Care Commercial, Post Acute Care PDS. Experience training, coaching, and mentoring. MBM preceptor experience. Proficiency in Nexlync, PowerPoint, MSWord, MS Teams, Microsoft Forms and or Kahoot. 10+ year experience in a front-line intake and or service delivery operations position. Travels to worksite and other locations as necessary.
Personal Information
Title: Dependable Employee
Timeline
Referral Specialist II
Elevance
09.2021 - Current
Health/Wellness Coach
Jenny Craig
06.2020 - 09.2021
Stylist Supervisor
Hair Club for Men and Women
11.2017 - 06.2020
Patient Care Technician II
DaVita Inc.
08.2012 - 03.2017
Vocational in General -
SMILEY HIGH SCHOOL
Some College (No Degree) - Surgical Technology
NATIONAL INSTITUTION OF TECHNOLOGY
Some College (No Degree) - Teacher Education
UNIVERSITY OF PHOENIX
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