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Skills

  • RFI Scanners
  • Auditing proficiency
  • Team management
  • Inventory management
  • Bill payment
  • Invoice generation
  • Supervision
  • Organization
  • Payroll liabilities
  • Cross-functional team collaboration

Work Experiences

  • Analyzed annual trends in Medicaid enrollment data.
  • Advocated for clients during Medicaid appeals, successfully overturning 54% of initial denials and securing coverage for critical services.
  • Learned client relations and project management to help with office needs.
  • Made it easier for clients to pay their bills by sending bill reminders and contacting them.
  • Kept accounting ledgers up to date by verifying and posting account transactions.
  • Analyzed over 3 Medicaid denials.
  • Provided excellent service and attention when dealing with customers face-to-face or over the phone.
  • Charged expenses to accounts and cost centers by analyzing invoices and expense reports.
  • Applied skills to improve departmental performance.
  • Working with team members and customers to find workable solutions improved operations.

Summaries

  • Communicative and team-oriented, with Adobe Creative Suite expertise.
  • Reconciliation procedures, accounting principles, payment processing, and report generation are all skills I have.
  • Expert in category with a strong aptitude for optimized and automated.
  • Medicaid Representative offerings that are meticulous 5 years of comprehensive experience in Miscellaneous.
  • Motivating leader who has built and managed procedure teams in the past.
  • Proven success in data analysis as well as a thorough understanding of method processes.
  • Multilingual and fluent in Spanish and French, with a strong grasp of cultural differences.
  • Individual who is enthusiastic and capable of working in both a team and independently.
  • With a team-oriented mentality, highly organized, proactive, and punctual.
  • Expert at processing payments on outstanding invoices in order to reduce debt and avoid unnecessary fees.

Accomplishments

  • Achieved a 66% improvement in client response times by introducing a standardized patient education process.
  • Utilized advanced data analysis tools like Tableau to identify discrepancies in Medicaid claims submission, leading to a 77% increase in accuracy.
  • Utilized SAP to systematically track Medicaid claims, improving accuracy and cutting reporting discrepancies by 57%.
  • Improved data security for Medicaid processing by ensuring compliance with PMP, reducing client information breaches to zero.
  • Ensured compliance with changing public health policies, updating processes to meet new Medicaid standards in 2020.
  • Advised hospital administration on Medicaid-related billing practices, reducing overdue claims by 36% within 3 months.
  • Implemented a targeted training program on public health policy implications in Medicaid service delivery, reducing misunderstandings and appeals by 34%.
  • Streamlined Medicaid application verifications through a new audit protocol, reducing turnaround time by 79%.
  • Trained a team of 17 on the proper Medicaid claims submission procedures, reducing rejection rates by 63%.
  • Facilitated weekly information sessions on Medicaid procedures, helping applicants understand coverage options and resulting in an 64% participation increase.

Affiliations

  • Engaged in the Government Healthcare Programs Forum by the Healthcare Financial Management Association (HFMA) since 2015, focusing on billing accuracy in Medicaid.
  • Member of the Public Health Social Work Association, collaborating on projects that include Medicaid service improvement and applicant education.
  • Obtained certification in Healthcare Policy and Administration from process, focusing on Medicaid reform and cost management.
  • Volunteer for program’s health fair, supporting Medicaid education and awareness efforts, resulting in a 66% increase in local enrollments.
  • Member of the Society of Government Service Professionals, specializing in process optimization of Medicare and Medicaid systems for increased productivity.
  • Contributing writer to the Medicaid Matters newsletter, sharing case studies on how to decrease backlog and process claims more efficiently.
  • Part of the National Association of Medicaid Directors (NAMD), regularly attending conferences on Medicaid case management best practices.
  • Contributed to research published by the Kaiser Family Foundation (KFF), analyzing the impact of state Medicaid expansions on low-income families.
  • Participant in the State Medicaid Data Analytics Roundtables since 2020, discussing key metrics for data-driven improvements in Medicaid case management.
  • Affiliation with the Center on Budget and Policy Priorities, where I contributed insights on Medicaid coverage expansion campaigns.

Certifications

  • Microsoft Office Specialist (MOS)
  • Project Management Professional (PMP)
  • AHIMA Certified Coding Associate (CCA)
  • Centers for Medicare & Medicaid Services (CMS) Certification
  • Revenue Cycle Certification (RCC) by ATPC
  • Certified Billing and Coding Specialist (CBCS) by NHA
  • Accredited Case Manager (ACM) by standard
  • Certified Patient Account Representative (CPAR)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • CompTIA Security+

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