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Skills

  • Medicaid policy compliance
  • Budgets
  • Supervision
  • Error Reduction Strategies
  • Client communication and engagement
  • Insurance industry experience
  • Excellent administrative abilities
  • Medicaid eligibility determination
  • Billing and claims reconciliation
  • Health insurance reimbursement knowledge

Work Experiences

  • Saved $10 by putting in place cost-cutting measures that addressed long-standing issues.
  • Answered 6 calls per several months to help customers with their questions and concerns.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Oversaw the delivery of system project by standard team, which resulted in framework.
  • Collaborated with metric customers to determine their needs and deliver initiative service.
  • Avoided potential fines.
  • Avoided costly state audits.
  • Looked for industry trends on social media and through online sources.
  • Processed 13 invoices and mailed documentation to clients each 18 months.
  • Advocated for medical providers.

Summaries

  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Selling over 17 policies weekly and maintaining excellent relationships with customers and coworkers are two of my strongest skills.
  • Medicaid Coordinator with 3 years of successful team leadership and vendor management experience.
  • Costs were consistently reduced while profits were increased.
  • Certified in PMP, with specialization in Medicaid eligibility determination and communication strategies that have enhanced client outcomes by 66%. Customer-focused problem solver.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Adept at identifying discrepancies in Medicaid records.
  • Over 14 years of experience obtaining information from policyholders and assisting with claim forms as an honest Insurance Clerk.
  • Achieved a 33% reversal rate.

Accomplishments

  • Reduced Medicaid-related billing discrepancies by 78% through enhanced coding accuracy and team training.
  • Developed and enforced Medicaid compliance strategies across 9 departments, resulting in successful audit outcomes.
  • Managed a caseload of 11 clients, ensuring all Medicaid applications met strict deadlines and compliance requirements.
  • Developed a cross-functional communication strategy that streamlined Medicaid application reviews, reducing approval timelines by 69%.
  • Verified patient income and eligibility documents, achieving an 61% approval rate with minimal appeals over the past year.
  • Trained 2 new employees in Medicaid guidelines and procedures, improving department efficiency by 77%.
  • Established a tracking system for client documentation that improved Medicaid application visibility and reduced status follow-ups by 81%.
  • Collaborated with team of 5 in the development of initiative.
  • Saved 12 annually by optimizing Medicaid application workflows and reducing repeated claims submissions.
  • Collaborated with case managers to resolve 15 complex Medicaid eligibility issues in two years, improving patient retention.

Affiliations

  • Association for Computing Machinery
  • County Public Health Department Medicaid Outreach Task Force
  • National Association of Medicaid Directors (NAMD)
  • Collaborated with the National Academy for State Health Policy (NASHP) to implement Medicaid policy improvements
  • International Council of Nurses
  • Medicaid Enterprise Systems Conference (MESC) - 2015
  • American Association of Healthcare Administrative Management (AAHAM)
  • American Marketing Association
  • American Health Information Management Association (AHIMA)
  • Illinois Association for Medicaid Advocacy

Certifications

  • Certified Managed Care Professional (CMCP)
  • Healthcare Reimbursement Specialist (HRS)
  • Certified Professional in Healthcare Quality (CPHQ)
  • Cisco Certified Network Associate (CCNA)
  • Medical Billing & Coding Certification (MBCC)
  • CompTIA Security+
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Healthcare Revenue Integrity Certification (HRIC)
  • Certified Health Insurance Specialist (CHIS)
  • Certified Revenue Cycle Specialist (CRCS)

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