I am a self-motivated individual with over 10 years in working in a fasted pace environment and strongly believe I am the best candidate for the Staff Services Manger I position. I have a working knowledge of how Routine Monitoring /compliance Investigation operates and I have many ideas to contribute to make the unit operate more efficiently.
Skills
Excellent verbal and written communication and relationship building.
Efficient in cross-departmental agency collaboration, case needs assessments, maintaining and updating records.
Excellent in problem-solving, and critical thinking.
Active listening.
Honest and Ethical.
Trained Collection Representative with the ability to resolve conflict issues in the Collection process.
Experienced presenter for training classes, community lectures, hardship hearings, and prospective clients
Ability to interview clients, assess their needs, and create a plan of action.
Knowledgeable about regulations Governing varies programs.
Knowledgeable in the following software, Microsoft Word, Windows 2000, Power Point, Excel, Automated Claims Management Systems (ACMS), Medi-Cal Eligibility Data System (MEDS), DMS Imaging Systems, Westlaw and Lexis-Nexis, R2W, SURS, Social Security Death Index, Equifax/Trans Union, and California State Bar Attorney Search.
Experience
08/2020 to Current
Case Investigator The Phia Group – Canton, MA,
I was redirected to Sacramento County as a Case investigator at the beginning of pandemic, by orders from Gavin Newsom.
Expert with Sacramento COVID-19 guidelines and how they apply to working individual's, schools and children.
Followed set protocol for contacting assigned newly diagnosed COVID-19 case patients and documented their symptoms, provided isolation / quarantine timeframes and connected them with resources.
Followed set protocol for contacting assigned newly diagnosed COVID-19 case patients and documented their symptoms, provided isolation timeframes, education, and connected them with resources.
Explained importance of contact tracing to prevent disease transmission and families and keep communities safe and healthy.
Completed data entry to facilitate case interview and elicited close contacts into Calconnect system immediately after obtaining information.
Worked successfully with diverse group of coworkers to accomplish goals and address issues related to COVID-19.
Prioritized and organized tasks to efficiently accomplish service goals.
Trained new onboarding employee and nurses.
02/2022 to Current
Hearing and Appeals Representative Moss Adams Llp – Portland, OR,
Expert witness and subject matter Routine Monitoring Visit and Compliance investigations and the laws that govern the WIC Program.
Analyze and interrupt the laws and regulation.
Stay current with the state and federal laws that govern the WIC program
Represent the State at formal and informal hearings for Vendors and participants who have been disqualified from the program or do not meet the federal guidelines for eligibility.
Work with Administration Law Judges and with Attorney at the Office of Legal Services.
Analyze case loads and prepare position statements.
Conduct per reviews.
Act as a custodian of records
Trained personnel on how to interpret and administer federal and state regulations.
Prioritized and organized tasks to efficiently accomplish service goals.
Juggled multiple projects and tasks to ensure high quality and timely delivery.
Demonstrated self-reliance by meeting and exceeding workflow needs.
Demonstrated leadership by making improvements to work processes and helping update create and new procedures in unit.
Act as lead in supervisors absent.
Motivated and encouraged team members to communicate more openly and constructively with each other.
06/2013 to 02/2015
Medi-Cal Eligibility California Department Of Health Services. (DHCS) – City, STATE,
Breast and Cervical Cancer Treatment Program (BCCTP)
Processed applications of beneficiaries applying for BCCTP program. Ensured applications were received timely and were completed in accordance with state and federal regulations.
Researched Medi-Cal providers within the Provider Master File to ensure they were eligible to provide service to BCCTP beneficiaries.
Participated in a special project to develop and revise BCCTP policy.
·Assigned Medi-Cal aid codes to beneficiaries; activate beneficiaries in MEDS eligibility database.
Tracked case status within BCCTP tracking system.
Wrote notifications to BCCTP beneficiaries regarding status of their application.
As Analyst of the Day (AOD), provided customer service to Medi-Cal providers, beneficiaries, and the general public.
Explained eligibility details and affordability options to patients with kindness and respect.
Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Prioritized and organized tasks to efficiently accomplish service goals.
Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.
02/2008 to 02/2015
Associate Governmental Program AnalystAGPA – City, STATE,
Lead in the unit.
Manage a caseload using a computerized collection management system
Recovered funds from the estates of deceased Medi-Cal beneficiaries in accordance with state and federal regulations.
Interpret the laws and regulations that apply to the Estate Recovery Program in order to be in compliance with collection policies of the Department
Negotiate payment of claim with the responsible party of the estate based on exemptions and asset value
Process Hardship Waiver Applications, write a position statement, and represent the Department's position at the Hardship Appeals Hearing
Research, analyze and summarize the issues of cases that are referred to the Attorney General
Confer with and provide supporting documentation to the assigned Deputy Attorney and staff attorney in order to assist in the resolution of collection or possible trial preparation work.
Consult with management to discuss complex cases, and formulate a plan with a variety of possible options for payment of claim.
Knowledgeable in the areas of trusts, life estates, property issues and exemptions that affect payment of Medi-Cal claims
Prepare liens for heirs and payment demands to escrow companies.
Create itemizations to be included with payment demands.
Explore skip tracing tools to locate heirs and assets of the estate.
01/2006 to 02/2008
Tax TechnicianRosanna Carson, FRANCHISE TAX BOARD – City, STATE,
In a reactive collections environment, assist taxpayers, attorneys, tax professionals and employers by analyzing accounts and making sound judgment on resolutions.
Educated callers and enforce compliance by reciting state tax laws and department policies.
Created payment plans, modified and released tax garnishments.
06/2005 to 01/2006
Associate Loan OfficerDIGITAL INSIGHT – City, STATE,
Worked in the Call Center communicate with over 100 credit unions nationwide
Answered frequent calls and assisted members with loan applications and bank account resolutions
Ran credit checks, analyzed information and made decisions of credit worthiness.
Performed daily maintenance of loan applicant database.
Modified, opened and closed customer accounts.
05/1999 to 06/2005
Universal Customer Services Rep IIWESTAMERICAN BANCORPORATION – City, STATE,
Provided excellent customer service to bank clientele by assisting with bank resolutions and questions
Analyzed accounts and informed clients of bank regulations and corporate policies.
Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
Met and exceeded productivity targets by handling every interaction with top-notch customer service.
Informed customers about billing procedures, processed payments and provided payment option setup assistance.
Education and Training
Expected in 05/2004 to to
Bachelor of Arts: Social Work California State University - Sacramento, GPA:
Expected in 05/1999 to to
Associate of Arts: Liberal Arts Solano Community College - , GPA:
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