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Medicaid Specialist Resume Example

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MEDICAID SPECIALIST
Professional Summary

Medicaid Specialist with a focus on developing high standards of practice, evaluating policies for effectiveness, auditing financial information and implementing necessary changes to programs and policies. Committed to improvement of financial outcomes for families and facilities.

Education and Training
Eastern Kentucky UniversityAssociate of Science: EducationCity, State
Skill Highlights
  • Relationship and team building
  • Staff training and development
  • Medicaid Eligibility
  • Network with State and Local agencies
  • Knowledge of Insurances and Managed Care
  • Contacts at financial institutions, Government agencies and Guardians

  • Conflict resolution
  • Patient-oriented
  • Personal and professional integrity
Professional Experience
Albuquerque Public SchoolsMarch 2011 to CurrentMedicaid Specialist
Albuquerque , NM

Reviewed Medicaid process at facility level. Implemented new software to track Medicaid applications for over one hundred facilities. Trained staff involved in the Medicaid pending process. Served as liaison between management, facilities, agencies and the community.

Actively maintained up-to-date knowledge of applicable state and Federal laws and regulations.

Established and maintained positive relationships with government regulators, residents, families, other area health care providers, physicians and community at large.

Albuquerque Public SchoolsJuly 2008 to March 2011Medicaid Manager
Albuquerque , NM

Case management for residents of Assisted Living Facilities and Skilled Nursing Facilities. Worked with hospitals, case managers, admission personnel and families to ensure proper placement of clients. Assisted families and skilled nursing facilities in Medicaid application process from start to finish. Trained staff in the Medicaid process. Completed all Medicaid applications. Executed documents for trusts and Guardianship annual accounting. Monthly network meetings for DCF and AHCA updates.

Sea Crest Healthcare ManagementMarch 2005 to July 2008Medicaid Specialist
City , STATE

Review Medicaid process at facility level. Completed quarterly audits for admissions, business office and social services. Completed quarterly training for new employees involved in the Medicaid process. Wrote detailed reports for management team for each facility visit. Conducted weekly conference calls with challenging facilities. Maintained updates on new policies and procedures within DCF, Department of Elder Affairs and AHCA. Networked with State and Local agencies. Cooperated with other health related agencies and organizations in community activities.

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78Average
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Resume Overview

School Attended

  • Eastern Kentucky University

Job Titles Held:

  • Medicaid Specialist
  • Medicaid Manager

Degrees

  • Associate of Science : Education

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