NANAYAW MENSAH
Laurel,MD
Summary
Diligent clinical administrative coordinator with background in coordinating clinical activities and improving patient care processes.
Recognized for implementing efficient workflows that enhance operational productivity and streamline communication across departments. Demonstrated expertise in managing patient schedules and maintaining detailed records, ensuring high standards of care and compliance.
Devoted professional proactively and quickly identifies best course of action for given scenarios. Confident handling tasks independently and in teams with highly organized approach to work. Strong advocate for those in need and committed to providing best possible service.
Overview
14
14
years of professional experience
Work History
Intake Specialist II
GI Alliance LLC
04.2025 - Current
- Manage day to day activities of patient and health care provider support requests and deliverables across multiple communication channels i.e. Phone, Fax, Chat, email, etc.
- Perform in-depth research into patient's Specialty medication coverage for office / home infusion setting. (Include clinical documentation review, benefit investigation and prior authorization request)
- Communicate effectively with healthcare providers, and patients regarding benefits and authorization status
- Educate Health Care Providers and patients on available Patient Support programs ie. Copay Assistance and Free Drug programs for the uninsured/underinsured when applicable
- Communicate effectively with payers, pharmacies, third party administrators and other departments to expedite the referral process.
- Coordinate all appropriate aspects of patient case management through to completion, using effective interpersonal skills to manage interactions
- Follow all requirements associated with compliance to program guidelines and relevant regulations, including HIPPA and patient privacy.
Clinical Coordinator
Optum Specialty Infusion Group
03.2019 - 01.2025
- Coordinate referral processes for home infusion and specialty pharmacy services on behalf of patients, facilities and provider offices.
- Work with referring physician offices, insurance carriers, and patients to navigate prior authorization requirements.
- Investigates patients’ insurance benefits, Process and monitor prior authorizations for new patients and members continuing therapy.
- Assist in reviewing, processing, and coordinating concurrent and retrospective referrals.
- Identify alternative funding and conduct administrative tasks in support of the patient enrollment to the program.
- Address and resolve any insurance coordination of benefits (COB) issues before services are rendered.
- Adjudicate pharmacy benefit claims, including Medicare Part D.
- Review and problem-solve returned, disputed, or rejected claims.
Patient Access Specialists
Alpha Consulting Corp.
05.2018 - 12.2018
- Manage day-to-day activities of health care providers, support requests and deliverables across multiple communication channels i.e., Phone, Fax, Chat, Email, etc.
- Perform in-depth research into patients’ insurance coverage, prior authorization and appeals on behalf of providers.
- Serve as a resource for health care providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for complex patient access situations, working closely with the Patient Access Management team to appropriately escalate/resolve reimbursement issues.
- Educate offices on programs and referral processes to ensure timely case processing.
Senior Reimbursement Support Analyst
Lash Group
01.2012 - 11.2018
- Handle day-to-day activity within reimbursement services, conduct research to ensure health insurance benefits or other financial assistance are available to patients for the products related to the program activities.
- Requests prior authorizations and help with appeal processes.
- Work on patients' behalf to identify and assess reimbursement coverage options for those with insurance and investigate financial options for those without.
- Serve as a resource to patients as well as other healthcare professionals regarding insurance coverage and billing for specific procedures and services.
Education
2 Year college coursework -
Northern Virginia Community College
HSD - undefined
Anglican Senior High School
Skills
- Expert in CPT, HCPC and ICD-10 Coding
- Medical & Pharmacy Benefits Verification and Prior Authorization Process
- Pharmacy claim Adjudication
- Proficient in MODMED & CPR EMR Platforms
Timeline
Intake Specialist II
GI Alliance LLC
04.2025 - Current
Clinical Coordinator
Optum Specialty Infusion Group
03.2019 - 01.2025
Patient Access Specialists
Alpha Consulting Corp.
05.2018 - 12.2018
Senior Reimbursement Support Analyst
Lash Group
01.2012 - 11.2018
HSD - undefined
Anglican Senior High School
2 Year college coursework -
Northern Virginia Community College