Billing and Audit Representative Resume Example

Responsible for telephonic outreach to Medicaid/Medicare Special Needs Population (SNP) members in gaining access to community-based support services through integration of medical and long term care (LTC) services pertaining to orientation, care plan development, completion of assessments and care coordination.

Assuring quality services are provided as part of an interdisciplinary team approach to problem solve and support health and create behavioral change while adhering to HIPPA policies to maintain client confidentiality.

Collaborate with discharge planners, physicians, and other health care professionals to ensure appropriate discharge planning, care planning, and coordination of acute care and long term care services that meet the member's needs.

Adhere to health care guidelines set forth by the Centers for Medicaid/Medicare Services (CMS).​ 

Responsible for assisting Medicaid/Medicare participants to create and establish a self-directed Long-Term Care (LTC) care plan while identifying and implementing care plan outcomes using a community-based network of resources and informal or voluntary services and supports.

Supervisory position responsible for organizing and overseeing athletic and recreation programs for Milwaukee Public Schools and adaptive sports and recreation programming.

Actively worked with recruitment and training of volunteer staff and evaluating programs for effectiveness of meeting the participants needs.

Customer Service position responsible for being the first point of contact engaging with Members to ensure customer safety and satisfaction by verifying current membership status, addressing all requests, answering questions, and other customer-focused duties associated with YMCA programs, policies, and procedures.

Business Development position working directly with National and International accounts, Account Executives, High-Volume clients and other company personnel to meet the customers needs in the daily maintenance of domestic and worldwide shipping and receiving.