Annie Mokonya

Experienced healthcare professional with 18+ years of experience in healthcare operations, patient coordination, referral management, insurance verification, and authorization processes across home health, hospital, and clinical environments. Experienced in verifying patient insurance eligibility and benefits, determining patient financial responsibility, obtaining and tracking prior authorizations, and ensuring payer requirements are met before services are provided. Skilled in maintaining accurate documentation, communicating with patients, providers, payers, and interdisciplinary teams, and following up on pending authorizations to prevent delays in care.

Strong background in HIPAA compliance, patient advocacy, referral and admission coordination, and denial prevention. Highly organized, detail-oriented, and committed to providing excellent patient and customer service.

COMMUNITY HEALTH LIAISON - PHRI - Annandale, VA

(2021-09)

• Verify patient insurance eligibility and benefits prior to initiating home healthcare services and referrals.
• Review insurance coverage and payer requirements to determine patient eligibility and appropriate services.
• Determine patient financial responsibility, including applicable copays, deductibles, and coinsurance, and communicate relevant information clearly to patients and healthcare partners.
• Obtain required prior authorizations from insurance payers for home healthcare services and monitor authorization status through completion.
• Document insurance verification, benefits, authorization information, payer requirements, and referral details accurately in appropriate systems.
• Track pending authorizations and follow up with payers and healthcare providers to prevent delays in patient services.
• Communicate with patients, physicians, case managers, nurses, therapists, hospitals, discharge planners, and payers regarding eligibility, referrals, authorization status, and service requirements.
• Review referral documentation for completeness and identify missing information or payer requirements that could delay admission or service initiation.
• Collaborate with scheduling, billing, clinical, and administrative teams to ensure accurate and timely referral and authorization workflows.
• Support denial prevention by ensuring required documentation, eligibility information, authorizations, and payer requirements are addressed before services begin.
• Manage multiple referrals and authorization requests simultaneously while prioritizing time-sensitive cases and maintaining accurate records.
• Identify recurring insurance, benefit, referral, or authorization issues and escalate unresolved matters to the appropriate team members.
• Maintain patient confidentiality and comply with HIPAA requirements when handling insurance, financial, and health information.
• Build and maintain strong relationships with referral sources and healthcare partners to support timely admissions and continuity of care.
• Meet referral and admission volume expectations while effectively prioritizing accounts and managing multiple cases in a fast-paced healthcare environment.

CONSULTANT SALES / TERRITORY MANAGER – SLEEP & RESPIRATORY - Flobee Services - Fort Washington, MD

(2019-05 - 2021-09)

• Managed healthcare accounts and maintained professional relationships with physicians, sleep centers, DME organizations, office staff, and other healthcare stakeholders.
• Evaluated customer and patient-care needs and recommended appropriate products and services based on clinical and operational requirements.
• Maintained accurate customer, account, and activity documentation using Salesforce CRM.
• Documented sales calls, customer interactions, product orders, and account information accurately and consistently.
• Coordinated with customers, management, and cross-functional teams to resolve issues and ensure timely delivery of appropriate solutions.
• Prioritized accounts and follow-up activities based on customer needs and time-sensitive requirements.
• Conducted quarterly business reviews with DME customers and maintained ongoing communication with healthcare partners.
• Developed professional relationships with prescribing physicians, sleep center staff, DME stakeholders, and key decision-makers.
• Executed sales and marketing initiatives while maintaining accurate CRM records and forecasting customer product orders.
• Provided education and support to healthcare professionals regarding sleep and respiratory products and services.

REGISTERED POLYSOMNOGRAPHIC TECHNOLOGIST – PEDIATRIC - CMNC (Children's) - Washington, DC

(2013-09 - 2019-05)

• Performed and documented pediatric sleep studies, including Baseline PSG, seizure montages, 10-20 EEG testing, and MSLT procedures.
• Performed complete patient hook-ups and monitored pediatric patients throughout sleep studies.
• Performed CPAP and BIPAP titrations and mask fittings while conducting routine patient assessments.
• Maintained accurate patient records and documentation while protecting confidential health information.
• Performed administrative duties involving patient data collection, record management, and billing-related information.
• Communicated effectively with patients, families, physicians, and clinical staff regarding procedures, patient needs, and test-related information.
• Collaborated with multidisciplinary healthcare teams in a fast-paced clinical environment.
• Followed established clinical, documentation, compliance, and patient-safety procedures.
• Utilized multiple monitoring platforms, including Alice 3, Alice 4, Alice 5, Somnostar, and Cadwell.

COMPLIANCE SPECIALIST - NRH (National Rehabilitation Hospital) - Washington, DC

(2009-11 - 2013-08)

• Supported HIPAA privacy and healthcare compliance activities and ensured required procedures and documentation were maintained.
• Conducted periodic audits to verify compliance with established policies and procedures.
• Maintained accurate compliance reports, records, and supporting documentation.
• Assisted with internal compliance monitoring activities and identified areas requiring follow-up or corrective action.
• Prepared audit documentation and audit responses while ensuring information was complete, accurate, and properly maintained.
• Collaborated with internal departments to support compliance requirements and resolve documentation issues.
• Maintained a high level of confidentiality when handling patient and organizational information.

STAFFING COORDINATOR - Maryland Treatment Center - Rockville, MD

(2005-02 - 2009-11)

• Coordinated staffing activities in a healthcare environment, including assignments, cancellations, license verification, orientation, and evaluations.
• Maintained accurate staff records and licensing databases to ensure required documentation and certifications were current.
• Monitored staffing needs using department census and acuity information and adjusted staffing accordingly.
• Coordinated with healthcare staff and departments to address scheduling changes and time-sensitive staffing requirements.
• Maintained confidential personnel information and documentation in accordance with organizational policies.
• Supported compliance with hospital policies, staffing guidelines, contractual requirements, and staff competency standards.
• Recorded staffing changes, sick calls, cancellations, and requests for leave.
• Collected department census and acuity data to anticipate staffing needs for upcoming shifts.

Master of Health Services Administration - Strayer University (2006-06)

Bachelor of Administration, Economic and Social Sciences - Paris VIII (1996-06)