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Division Of Medicaid Medicaid Specialist Resume Example

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Jessica Claire
, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary
Motivated Eligibility Specialist with experience successfully managing and monitoring eligibility information for members and groups. Highly skilled at facilitating program approval or denial through qualifications assessment, fact checking and record keeping. Confident and committed to promoting positive customer outcomes through dynamic communication and exemplary engagement skills.
Skills
  • Microsoft Software
  • Analyst
  • Benefits
  • Communication skills
  • Critical thinking
  • Client
  • Customer service
  • Database
  • Documentation
  • Filing
  • Meetings
  • Microsoft Software
  • Mail
  • Office
  • Policies
  • Problem solving
  • Coding
  • Public relations
  • Sat
  • Self-motivated
  • Supervisor
  • Phone
  • Phones
  • Time management
  • Written
Work History
10/2019 to Current
DIVISION OF MEDICAID, Medicaid Specialist City, STATE,
  • Interview applicants to determined eligibility for all state Medicaid programs.
  • Evaluate incoming referrals and manages verification of Benefits and Eligibility.
  • Maintain effective public relations with medical facilities and federal, state, county, and city agencies within assigned territory.
  • Investigate and verify the accuracy of information provided by recipients under the Medicaid programs to determine compliance with State and Federal laws, rules, and regulations.
  • Identify and resolve discrepancies in facts, data, and information provided during the course of eligibility reviews.
  • Consistently complete reviews of all assigned cases within established deadlines to prevent any delays in patients' case or care.
  • Provide customer service by responding to phone calls, written, and electronic inquiries in a timely manner and educating customers on Medicaid policies and programs to inform customers and resolve any questions or concerns.
01/2014 to 09/2019
Office Assistant/Office Clerk NA City, STATE,
  • Created, compiled, and maintained files.
02/2019 to 03/2019
JACKSON MEDICAL MALL City, STATE,
  • Assisted with coordinating and assigning work to office staff.
  • Answered phones in a professional manner and directed calls to appropriate persons or take detailed messages.
  • Maintained and updated filing, mailing, and database systems.
  • Reviewed client's files to ensure that information was updated and complete.
  • Coordinated all incoming and outgoing shipments/mail/packages.
  • Sat with each department supervisor to learn about different areas of coding: ancillary, pathology, pediatrics, medicine, and obstetrics/gynecology.
  • Performed office duties upon request.
  • Practiced coding from patient's electronic record.
  • Attended departmental meetings.
Education
Expected in May 2019
BACHELOR OF SCIENCE: Health Informatics Information Management
University of Mississippi Medical Center - Jackson, MS
GPA:
Expected in July 2015
ASSOCIATE: APPLIED SCIENCE Dental Assisting Technology
Hinds Community College - Jackson, MS
GPA:
Expected in August 2014
:
ASSOCIATE OF ARTS Hinds Community College - Raymond, MS
GPA:
Work History
10/2019 to Current
DIVISION OF MEDICAID, Medicaid Specialist
Pearl, MS
  • Interview applicants to determined eligibility for all state Medicaid programs.
  • Evaluate incoming referrals and manages verification of Benefits and Eligibility.
  • Maintain effective public relations with medical facilities and federal, state, county, and city agencies within assigned territory.
  • Investigate and verify the accuracy of information provided by recipients under the Medicaid programs to determine compliance with State and Federal laws, rules, and regulations.
  • Identify and resolve discrepancies in facts, data, and information provided during the course of eligibility reviews.
  • Consistently complete reviews of all assigned cases within established deadlines to prevent any delays in patients' case or care.
  • Provide customer service by responding to phone calls, written, and electronic inquiries in a timely manner and educating customers on Medicaid policies and programs to inform customers and resolve any questions or concerns.
01/2014 to 09/2019
Office Assistant/Office Clerk
CLEO'S TAX OFFICE Canton, MS
  • Created, compiled, and maintained files.
02/2019 to 03/2019
JACKSON MEDICAL MALL
Jackson, MS
  • Assisted with coordinating and assigning work to office staff.
  • Answered phones in a professional manner and directed calls to appropriate persons or take detailed messages.
  • Maintained and updated filing, mailing, and database systems.
  • Reviewed client's files to ensure that information was updated and complete.
  • Coordinated all incoming and outgoing shipments/mail/packages.
  • Sat with each department supervisor to learn about different areas of coding: ancillary, pathology, pediatrics, medicine, and obstetrics/gynecology.
  • Performed office duties upon request.
  • Practiced coding from patient's electronic record.
  • Attended departmental meetings.
Skills
  • Microsoft Software,
  • Analyst, Benefits, communication skills, Critical thinking, client, Customer service, database, Documentation, filing, meetings, mail, office, policies, problem solving, Coding, public relations, Sat, Self-motivated, supervisor, phone, phones, Time management, written
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    Resume Overview

    School Attended
    • University of Mississippi Medical Center
    • Hinds Community College
    • ASSOCIATE OF ARTS Hinds Community College
    Job Titles Held:
    • DIVISION OF MEDICAID, Medicaid Specialist
    • Office Assistant/Office Clerk
    • JACKSON MEDICAL MALL
    Degrees
    • BACHELOR OF SCIENCE
    • ASSOCIATE

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