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Skills

  • Process optimization
  • First Aid/CPR
  • Team management
  • Client interviewing techniques
  • Program knowledge
  • Supervision
  • Medicaid policy interpretation
  • Case management
  • Conflict resolution
  • Communications

Work Experiences

  • Chose qualified applicants to refer to potential employers for job placement.
  • Analyzed Medicaid policies and applied complex regulations to ensure applicants met specific eligibility requirements in Portland.
  • Sorted jobs that were relevant to candidates' interests and forwarded the information to them.
  • Used computer-assisted guidance packages such as skills assessment tools, career planners, psychometric tests, and personal inventories to help clients determine their strengths and weaknesses.
  • Coordinated with cross-functional teams.
  • Coordinated with cross-functional teams to implement an online application system that reduced processing errors by 84%.
  • Authored detailed eligibility reports for Washington Medicaid programs.
  • Audited eligibility assessments completed by other specialists, ensuring adherence to Medicaid quality standards across 5 cases monthly.
  • Coordinated weekly case reviews.
  • Followed guidelines when reviewing applicant data to determine eligibility for financial assistance.

Summaries

  • Achieved a 48% increase in benefit approvals.
  • Achieved 64% approval rates in first-time applications.
  • Coordinated cross-functional teams.
  • Considered a team player who excels at multitasking.
  • Adept at providing detailed reports and data analysis for Washington Medicaid programs, achieving a 27% increase in benefit approvals and compliance.
  • Achieved quicker resolutions.
  • Employers and community organizations are contacted to identify job opportunities for clients.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Conducted data analysis for Texas Medicaid programs.
  • Dedicated to expanding job opportunities by forging strong bonds with employers and job seekers.

Accomplishments

  • Reduced incomplete applications through targeted outreach, resulting in a 35% increase in successfully processed Medicaid claims.
  • Provided bi-lingual outreach and education services to community members, resulting in a 26% increase in Medicaid applications from non-English speaking households.
  • Resolved product issue through consumer testing.
  • Mastered the use of case management software systems to track eligibility status changes across over 5 active Medicaid cases.
  • Reviewed 7 Medicaid applications each month, identifying eligibility compliance issues and reducing application rejection rates by 83%.
  • Effectively assisted non-English-speaking applicants, increasing equitable service delivery and improving client satisfaction by 29%.
  • Implemented a client feedback system for the Medicaid application review process, which improved overall client satisfaction by 80%.
  • Reduced late recertification submissions by 82% through a targeted client communication campaign and improved follow-up processes.
  • Collaborated on cross-department initiatives to verify income and residency status for Medicaid applicants, preventing fraud and retaining compliance.
  • Spearheaded efforts to develop a digital Medicaid status tracking tool that gave clients real-time updates, cutting phone inquiries by 67% and boosting client satisfaction.

Affiliations

  • Alliance for Community Health Plans (ACHP)
  • Society of Women Engineers
  • American Academy of Health Care Providers in the Addictive Disorders (AAHCP)
  • Center for Health Care Strategies (CHCS)
  • Association for Community Affiliated Plans (ACAP)
  • National Academy for State Health Policy (NASHP)
  • Association of State and Territorial Health Officials (ASTHO)
  • Lions Club
  • Freemason
  • Association for Supply Chain Management (APICS)

Certifications

  • Certified Public Accountant (CPA)
  • Apple Certified Associate (ACA)
  • Certification in Public Health Informatics (CPHI)
  • HIPAA Compliance Certification
  • Certified Revenue Cycle Specialist (CRCS)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Medical Office Manager (CMOM)
  • Certified Healthcare Auditor (CHA)
  • First Aid/CPR Certified
  • Certified Public Accountant

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