Tonika Guilford, Prior Authorization Expert on Influential Women

Influential Woman · Healthcare Administration

Tonika Guilford

Prior Authorization Expert, Northeast Georgia Hospital System

Atlanta, GA

2Awards received

Certifications · Degrees · Memberships

Degree Associate's Degree from City Colleges of Chicago Degree Bachelor's in Business Administration from Western Governors University (graduating next month) Degree Currently enrolled in Master's of Business and Science (MBS) program at Brenau University in Gainesville Degree Georgia Cert Certified Dialysis Technician Cert Certified Professional Coder (CPC) Cert Certified Coding Specialist Cert Billings and Collections Certification Cert Medical Administration Certification Cert Time Management Certification Cert OSHA Compliance Certification Cert HIPAA Compliance Certification Cert Behavioral Technician Training Cert Healthcare Team Operations Certification Cert Micro-credentialing Award in Healthcare Administration Member NAACP

Her Story

About Tonika

My career in healthcare administration spans 25 years, beginning straight out of high school as a candy striper with Advocate Healthcare and transitioning to a permanent role in 2000 in revenue cycling and patient registration. From 2013 to 2019, I worked with DaVita and Fresenius in administrative dialysis while simultaneously working for Advocate, serving as both a dialysis technician on the clinical side and a liaison on the non-clinical side to represent patients and their families. My path into nephrology was deeply personal - my mother was a dialysis patient, and when I became so inquisitive about her care, the nephrologist asked if I wanted a job. I became a dialysis technician because I wanted to get my mother the best care, and she stayed with us for 16 years after that because both of us were knowledgeable. This experience made me realize that the dialysis patient is not the only person going through it - their family is going through it as well, and I'm a testament to that. So I wanted to advocate for both the patient and the families. In 2019, I moved to federal employment where I served as a supervisory administrative officer with the Department of Veteran Affairs, working across all 50 states in areas including budgeting, strategic planning, recruitment, HR, and mental health. Serving our veterans has been one of the most important things for me over the past 17 years. As of October 2025, I have been working as a pre-certification specialist for Northeast Georgia Health Systems in revenue cycling. Throughout all my roles, my key responsibilities have remained consistent: financial clearances, pre-certification, verification, anything that has to do with payer rules, coordination of benefits, and strategic planning. My main goal has always been making healthcare run more smoothly by ensuring everything is done correctly on the preregistration side and front end, so that when it comes back to prior authorization, revenue cycling, and billing, everyone is coordinating together.

Her Interview

Ten minutes with Tonika

01What do you attribute your success to?

I would contribute my success to being a humanitarian and having empathy instead of sympathy for people. I always want to see myself in the other person's shoes so that I have empathy for them, instead of sympathy, because people feel so vulnerable when they feel like they're a victim, and I never want to feel like a victim, so I never want anyone else to feel that way either. My success is because of always seeing myself and placing myself in other people's shoes.

02What’s the best career advice you’ve ever received?

The best career advice I've ever received came from my longtime mentor and my director, Dr. Crystal Vasquez, who is the Director of the Clinical Resource Hub with the Department of Veteran Affairs. She's always told me, 'Let them tell you no. Apply for any and everything, do any and everything that you want. Even if you do not have the credentials yet, you apply for it, and you let them tell you no. That way, you can see what it is that you need, and you can learn, and you can grow from that, and always continue your education, because you will forever be learning something.' She's the person who pushed me to actually continue with my educational career, and honestly, she was someone that was just planting seeds that I didn't know she was actually planting inside of me, and I will forever be grateful to her for that.

03What advice would you give to young women entering your industry?

To never give up on yourselves and continue to push through, no matter the adversity, always believe in yourself.

04What are the biggest challenges or opportunities in your field right now?

The biggest challenge that I've ever gone through in my career is with this current administration, where, as a federal employee, we've had a light shed on us for the past year, and it has not been a good light. A lot of people don't understand the things that we go through every single day being federal employees, and to see a lot of the comments that I was seeing on social media and all of these platforms about how lazy federal workers are, and they were applauding us losing our positions. It's very hard to get a federal employee job - it's a strenuous process. So, while they were actually cheering on our demise, they had to realize that we were going to be the people interviewing for the roles that they were in now. That's the most challenging thing that I've been through in my career, where people really didn't understand where we were at, being federal employees.

05What values are most important to you in your work and personal life?

Family and having it be a family environment is most important to me. I think that a lot of people have jobs, but for me, my career is very important to me, and having a work-life balance with the people you actually work with, and it being a family-oriented situation. A lot of people are in places that they're at a job, and it's not their career, and they don't like going to that place. In all of my years, at the three places that I've worked at, it's always been a family-oriented situation, so it made me more excited to actually go do something that I love.

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