Tonya Harris Email & Phone Number

Mckinney, Tx, Us

Mckinney, Tx, Us

• Manages multi-channel engagement to enhance healthcare professional (HCP) experiences and address coverage requirement inquiries using approved communication tools.• Educates HCPs and their staff on patient assistance programs, emphasizing their role in facilitating patient access to therapy, and provides training on web-based tools.• Serves as an expert on payer and pharmacy information, communicating changes to stakeholders proactively and coordinating with internal and external teams for market access and patient services.• Analyzes market access trends and payer policies, maintains knowledge of coverage and authorization processes, and collaborates with sales teams to ensure optimal patient service and product access.

Dallas, Texas, United States

• Established operational protocols for new initiatives, resulting in a 40% increase in program efficiency and early achievement of objectives.• Managed a team of navigators, ensuring the delivery of community-based services and maintaining high standards of program execution.• Conducted community engagement activities to foster partnerships and facilitate healthcare enrollment processes within the coverage area.• Designed and implemented evaluation systems to measure program effectiveness and facilitate continuous improvement.

Dallas, Texas

• Developed operational processes for managing health insurance premium and cost-sharing programs in collaboration with financial leadership.• Ensured compliance with insurance requirements by staying current with financial responsibilities and managed care plan details through continuous training.• Conducted educational sessions on health insurance basics and Affordable Care Act enrollment for agency staff in partnership with the Case Management Director.• Managed patient caseload, maintained program benefits to meet regional standards, and facilitated communication between insurance companies and patients to preserve benefit continuity.

• Ensured accurate entry of payor contracts and insurance carriers into the patient accounting system, maintaining data integrity for billing processes.• Developed and executed an insurance verification training program, enhancing the admissions team's understanding of benefits coverage. • Collaborated with senior executives, including the Chief Operating Officer, to address and resolve insurance-related issues, contributing to organizational efficiency.

• Secured necessary authorizations and pre-certifications by liaising with insurance carriers, ensuring patient compliance with Medicare, Medicaid, and third-party payer guidelines.• Conducted comprehensive medical reviews for prior authorization requests and maintained a meticulous record-keeping system to track procedures, denials, and approvals.

• Oversaw the delegation of daily tasks and managed staff scheduling to ensure adherence to productivity targets and maintain uninterrupted business operations.• Developed training protocols and collaborated with the collections team to ensure accurate cash posting and comprehensive documentation, contributing to the enhancement of operational procedures.

• Ensured accurate insurance coverage verification and patient data updates, maintaining meticulous records in the company's system.• Executed comprehensive reviews of patient insurance details, such as coverage, deductibles, and potential carrier payments, ensuring financial clarity and accountability.• Collaborated with cross-functional teams to address and resolve claims discrepancies, while also ensuring adherence to insurance requirements through continuous professional development.

Patient Advocate Certificate 18 Ceus

Business Administration