Rachael Soucia
Boston
Summary
Healthcare operations and reimbursement specialist with 8+ years of experience navigating insurance, claims, authorizations, and payer processes across hospital and specialty settings. Proven ability to translate complex healthcare and reimbursement workflows into actionable insights for cross-functional teams. Experienced in process optimization, stakeholder communication, and supporting technology-enabled solutions that improve operational efficiency and access outcomes.
Overview
8
8
years of professional experience
1
1
Certification
Work History
PATIENT SUPPORT ADVOCATE
Shields Health Solutions
Boston
05.2022 - Current
- Secured over $10M in financial assistance in 2025, ensuring uninterrupted access to critical oncology medications.
- Led an AI integration initiative across multiple clinics to improve patient intake, scheduling, and communication workflows, in partnership with IT and clinical teams.
- Serve as a subject matter expert on insurance authorization, payer requirements, and claims workflows across oncology and specialty therapies.
- Partner cross-functionally with IT, operations, pharmacy, and external vendors to streamline intake, authorization, and referral processes.
- Drive workflow optimization initiatives using electronic referral systems, and data-driven process improvements.
- Support healthcare technology integrations to improve intake efficiency, documentation accuracy, and communication.
- Translate complex payer rules and authorization outcomes into clear, actionable guidance for internal teams and external stakeholders.
MANAGED CARE COORDINATOR
Beth Israel Deaconess Medical Center
Boston
07.2018 - 05.2022
- Coordinated patient care plans with healthcare teams and insurance providers.
- Facilitated communication between patients, providers, and payers for efficient care delivery.
- Reviewed patient medical records for compliance with managed care guidelines.
- Educated patients on coverage options and benefits available through their plans.
- Conducted assessments to identify patient needs and appropriate services.
- Tracked utilization data to identify trends in healthcare utilization across different networks or regions.
Education
BACHELOR OF SCIENCE - PUBLIC HEALTH, MINOR IN PSYCHOLOGY
American International College
Springfield05.2018
Skills
- Insurance & Payer Process Navigation
- Claims & Authorization Workflows
- Healthcare Operations & Process Optimization
- Cross-Functional Collaboration
- CRM & Multi-System Documentation
- Data Interpretation & Workflow Analysis
- Stakeholder Communication
- AI & Technology-Enabled Healthcare Solutions
- HIPAA & Compliance Awareness
Certification
• Certified Pharmacy Technician (CPhT)
Timeline
PATIENT SUPPORT ADVOCATE
Shields Health Solutions
05.2022 - Current
MANAGED CARE COORDINATOR
Beth Israel Deaconess Medical Center
07.2018 - 05.2022
BACHELOR OF SCIENCE - PUBLIC HEALTH, MINOR IN PSYCHOLOGY
American International College