LASALLE PINNOCK
Sacramento
Summary
Motivated Team Lead possessing excellent leadership and planning abilities. Focused on delivering high-quality products on tight schedules. Monitors, trains, and encourages employees to improve skills and meet demanding targets. History of successfully developing and managing strong teams through proactive training and issue management.
Overview
17
17
years of professional experience
Work History
Enrollment Team Lead
Strive Health
03.2023 - 01.2025
- Led team of 10 employees to enroll kidney patients in dedicated kidney care programs, enhancing patient access to necessary resources.
- Supported team in achieving quarterly and yearly enrollment goals, contributing to overall departmental success.
- Monitored team performance through individual coaching sessions to enhance skill development.
- Created training materials and providing my team and new hires with training and procedure updates.
- Guided team to meet yearly targets, resulting in achievement of highest quarterly bonuses in market.
Self Pay/Billing Specialist
US Oncology
02.2020 - 03.2023
- WORKED WITH COMMERCIAL INSURANCE, MEDICARE AND MEDICAID REGARDING CLAIMS STATUS AND PAYMENTS.
- Managed appeals and escalations with insurance payers and leadership to effectively resolve claim issues.
- Assisted insurance patients with self-pay options and followed up on claims status to ensure timely resolution.
- Supported team in achieving weekly and monthly departmental goals through collaboration and proactive management.
- Compiled detailed reports and spreadsheets of weekly and monthly totals of payments received from insurance payers.
Member Engagement Specialist
Catasys
05.2019 - 02.2020
- Conducted motivational interviewing to facilitate member enrollment in beneficial programs.
- Executed outbound calls to engage identified members about the OnTrak program.
- Assisted care-avoidant population in joining innovative program to enhance physical and mental health.
- Receive inbound calls and route appropriately.
Medical Management Specialist II
Anthem Blue Cross BlueShield
Atlanta
04.2017 - 09.2018
- Managed care for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize health care across the continuum and facilitating access to appropriate services.
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
- Implemented care plans by facilitating authorizations and referrals within the benefits structure.
- Coordinates internal and external resources to meet identified needs.
- Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Assisted in developing utilization and care management policies and procedures, chaired and scheduled meetings, presented cases at Grand Rounds/Care Conferences, and participated in interdepartmental and cross-brand workgroups.
- May require the development of a focused skill set including comprehensive knowledge of specific disease processes or traumatic injury and functions as a preceptor for new care management staff.
- Participates in audit activities and assists supervisors with management of day-to-day activities, such as monitoring and prioritizing workflow, delivering constructive coaching and feedback, and developing associated corrective action plans at direction of the manager.
- Developed training materials, conducted quality audits, and evaluated processes while testing and monitoring system enhancements.
- Implemented the Atlanta Integrated Health Model to enhance patient care coordination.
- Negotiate rates of reimbursement, as applicable.
Billing Supervisor
CSI Laboratories
Alpharetta
01.2016 - 01.2017
- MANAGED STAFF OF 12 BILLING ACCOUNTS RECEIVABLE AND FRONT END AGENTS.
- ENSURED AND MONITORED DEPARTMENTS PRODUCTIVITY.
- Monitored staff performance to ensure achievement of weekly and monthly goals.
- Created scorecards and targets for staff to drive departmental success.
- DEVELOPED SCORECARDS AND METRICS FOR EACH STAFF MEMBER.
- Implemented one-on-one coaching sessions to develop staff and enhance departmental effectiveness.
- Equipped team with resources to enhance revenue generation efforts.
- Oversaw operations in Alpharetta, GA
Quality Training Specialty Lead
Anthem Blue Cross BlueShield
Atlanta
01.2012 - 01.2015
- Developed and implemented quality improvement metrics, enhancing client satisfaction and achieving success rate exceeding 85%.
- Achieved department KPI targets, which included service levels, handle time, ACW, talk time, and not ready metrics, along with HEDIS goals.
- Provide 1-on-1 coaching and development for under performers, assessing skill set benchmark and determining proper performance management.
- Develop quarterly recognition incentives and training programs that improve member satisfaction.
- Created and developed member outreach and education quality programs, starting with a pilot program.
- Manage staff of 53 non-clinical agents with assistance on handling escalated calls.
- Created employee career path development track for agents, boosting retention rates and facilitating promotional opportunities.
- Exhibited effective recruitment that enhanced team performance by securing appropriate complementary skills sets.
Team Lead
ACS / XEROX
Atlanta
01.2008 - 01.2010
- Resolved billing/claims concerns and customer service inquiries for GA Medicaid providers, enhancing provider satisfaction.
- Provided tips and instructions to staff on how to handle difficult calls and what policies to use that assisted with completing those calls and improving effectiveness of the team.
- Assisted help desk with supervisor calls and escalations, ensuring timely resolution of member issues.
- Ensured operations were in compliance with OSHA, and Joint Commission Accreditation Certification with 90%+ quality scores.
- Documented calls accurately, maintaining compliance with policies and procedures to support operational integrity.
Education
High School -
John F Kennedy High School
Skills
- Enrollment strategy
- Client Relations
- Customer relationship management
- Project Management
- Program Development
- Process Improvement
- Quality Assurance
- Quality improvement
- Change Management
- Workflow optimization
- Work-Flow Analysis
- Team management
- Client management
- Training development
- Performance coaching
- Conflict resolution
- Motivational interviewing
- Claims processing
Timeline
Enrollment Team Lead
Strive Health
03.2023 - 01.2025
Self Pay/Billing Specialist
US Oncology
02.2020 - 03.2023
Member Engagement Specialist
Catasys
05.2019 - 02.2020
Medical Management Specialist II
Anthem Blue Cross BlueShield
04.2017 - 09.2018
Billing Supervisor
CSI Laboratories
01.2016 - 01.2017
Quality Training Specialty Lead
Anthem Blue Cross BlueShield
01.2012 - 01.2015
Team Lead
ACS / XEROX
01.2008 - 01.2010
High School -
John F Kennedy High School