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Skills

  • RFI Scanners
  • Customer Support Responsiveness
  • Case Resolution Efficiency
  • First Aid/CPR
  • Customer feedback loop implementation
  • Collaboration with state agencies
  • Supervision
  • Invoice generation
  • Planning and coordination
  • Educational material development

Work Experiences

  • Kept my program knowledge up to date by doing budget management and cross-functional collaboration.
  • Used Workday to compile data gathered from various sources.
  • Achieved a 85% reduction in complaints.
  • Analyzed the needs of customers and recommended the best options for them, upselling products and services.
  • Site evaluations, customer surveys, and team audits were all things I did.
  • Addressed system enrollment concerns.
  • Was in charge of all tasks delegated to me, including client relations and project management.
  • Assisted in the creation of program procedures.
  • Analyzed enrollment data to provide reports for senior management, influencing decision-making on strategic planning and contributing to a 20% enrollment rate improvement.
  • Responded quickly, usually within 8 hours when customers called with questions.

Summaries

  • Microsoft Excel expert who excels at meeting and exceeding sales targets.
  • Standard and framework have a proven track record.
  • With hands-on experience, eager to learn new skills and advance knowledge.
  • Multilingual and fluent in Portuguese and French, with a strong grasp of cultural differences.
  • Proficient in promoting standard by leveraging performance reporting and risk assessment knowledge.
  • Student pursuing a Miscellaneous degree who is eager to contribute developed knowledge in the role of Enrollment Broker.
  • Achieved 16% adherence to enrollments.
  • Achieved 46% faster response rates on enrolled cases.
  • Service-oriented and quality-focused, with 16 years of Miscellaneous experience and a track record of success.
  • Motivating leader who has built and managed framework teams in the past.

Accomplishments

  • Designed workflow optimizations that reduced staff overtime by 75% and improved overall enrollment processing speed.
  • Reduced non-compliance cases by 50% by retraining staff on new federal guidelines during open enrollment season.
  • Created a multi-lingual enrollment guide that improved the accessibility of services for non-English speaking clients, increasing participation by 82%.
  • Recognized by management for increasing healthcare plan member satisfaction by 32% through proactive solutions and personalized service.
  • Played a key role in a state-funded initiative targeting underinsured populations, increasing enrollment completion rates by 65% within several months.
  • Coordinated enrollment appeal processes, successfully overturning incorrect denials in 82% of cases within the past year.
  • Monitored enrollment compliance to ensure adherence to state Medicaid standards, helping the organization avoid costly penalties.
  • Served as a subject matter expert on Medicare/Medicaid enrollment, speaking at procedure to educate industry professionals about best practices.
  • Reduced mistaken Medicaid terminations by 34% through monthly audits and cross-referencing enrollment databases.
  • Conducted weekly consultative sessions with high-risk members, improving overall retention rates for Medicaid and Medicare clients by 53%.

Affiliations

  • Member, American Health Information Management Association (AHIMA) - Focused on accurate, effective use of health data and CRM systems.
  • Certification Holder, Certified Healthcare Access Associate (CHAA) - Specialized in handling complex cases in healthcare enrollment.
  • Member, National Association of Medicaid Program Integrity (NAMPI) - Collaborates with state officials to ensure regulatory compliance in health services.
  • Participant, Health Policy Institute - Enhanced knowledge of policy trends influencing Medicaid/Medicare enrollment processes.
  • Affiliate, National Association of Health Data Organizations - Supports initiatives aimed at improving healthcare data management.
  • Participant, National Healthcare Forum - Contributed to discussions on streamlining Medicaid/Medicare data collection processes.
  • Volunteer, Community Healthcare Access Program 2016 - Assisted in enrolling underserved populations into Medicaid/Medicare with a focus on improving outreach.
  • Participant, CMS Provider Enrollment Training - Improved expertise in both state and federal regulations to ensure compliance during client interactions.
  • Member, Healthcare Information and Management Systems Society (HIMSS) - Focused on implementing effective CRM solutions for healthcare providers.
  • Participant, Continuing Education Program in Data Privacy for Health Insurance - Gained essential skills for safeguarding client information during enrollment.

Certifications

  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Navigator (CN) by Centers for Medicare & Medicaid Services (CMS)
  • Google Certified Professional Cloud Architect
  • Certified Healthcare Access Associate (CHAA)
  • AHIP Medicare/Medicaid Certification
  • SHRM Certified Professional (SHRM-CP)
  • ServSafe
  • Medicaid Services Certification from process
  • Certified Medicaid Planner (CMP) by CMP Board
  • Certified User of system for Client Enrollment Systems

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