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social services examiner ii resume example with 17+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Summary
Detail-oriented Team Supervisor skilled in productivity improvement and efficiency. Manages multiple projects under tight deadlines.  Proven ability to build dynamic teams that achieve continual process improvement.
Skills
  • Analytical thinker
  • Exceptional organizational skills
  • Creative problem solver
  • Local government background
  • Employee relations
  • Project management
Professional Experience
Social Services Examiner II, 02/2012 to 08/2017
1-800-Flowers.Com, Inc.Atlanta, GA,
  • Lateral transfer within Medicaid Division.
  • Serving as a working supervisor over a team of Social Service Examiners I with ability to multi-task, meet deadlines and team goals in high-volume unit and maintain/exceed established production levels.
  • Interpretation of Federal, State, and local policies and procedures as they relate to the eligibility of the program ~ Generation of Fair Hearing packet to defend the actions of the agency at an Appeals Hearing presided over by a State Administrative Law Judge.
  • Act as first point of contact for clients/representatives that dispute the action of the agency in the form Telephone Conference ~ Proficient in ability to explain the determination adequately to deter a request for Fair Hearing.
  • Keep up-to-date on Federal and State regulations via ADMs, GISs, and INFs, as well as NYS Estates, Powers, and Trusts laws~ Interpret and distribute/discuss with team ~ Coordination with other team supervisors and unit supervisor as necessary.
  • Reviewing Examiners' case recommendations & eligibility determinations for initial applications and annual renewals of Medicaid coverage for Skilled Nursing Facilities and the enrollment and renewal of Managed Long-Term Care recipients.
  • Identify errors in Examiner's determination, make corrective recommendations, review maintenance requests, approve collateral investigations and extension requests.
  • Assist in the formulation/revision of policies and procedure to ensure maximum efficiency within the unit.
  • Continual monitoring of the performance of team members to maintain case production at established level - additional training and/or mentoring when necessary.
  • Maintain cooperative relationships with other Social Services divisions, community groups, attorneys, and other outside agencies.
Training Supervisor, 10/2009 to 02/2012
Abb LtdQuincy, MA,
  • responsible for a team of 4-6 new-hire employees.
  • Complete 6-month structured and comprehensive training of the Medical Assistance program consisting of identifying applicant's category, budgeting, appropriate documentation, case processing, knowledge and comprehension of applicable Federal & State regulations and Extra Help programs, Plan, coordinate, and manage the activities within assigned group.
  • Maintain training program, policy and procedural revisions, and conformity with three other Social Services Examiner II trainers ~ cross-train groups when necessary.
  • Required to analyze the judgement, initiative, and performance of new employees as compared to demands of position.
  • Oversee and make suggestions to help each Examiner manage, organize, and prioritize a high-volume caseload in most efficient manner possible.
  • Make recommendations to Administration throughout training period regarding each new employee's ability to understand the program, follow directions ~ Periodic employee training evaluations & overall assessment provided to Administration for final decision to maintain or terminate employment during probationary timeframe of 26 weeks.
Social Services Examiner I, 09/2005 to 09/2009
Graphic Packaging Holding CoKingston Springs, TN,
  • Interview applicants for financial assistance program.
  • Evaluate applicant's financial eligibility for assistance, including the initial categorical eligibility and additional services and/or programs available to applicant.
  • Knowledge of laws pertaining to Social Security, Unemployment, Workers Compensation, and No-Fault Insurance.
  • Processing of annual recertification for continued Medical Assistance as well as maintenance requests including, but not limited to: Inpatient Conversions of coverage, establishment of Supplemental Needs or Pooled Trusts, additions/deletion of members on the case, Short-term care eligibility, and financial determination or the Medicare Savings Program, MBI-WPD, PCAP, and HCBS waivered programs.
  • Calculate and process client requests for reimbursement of out-of-pocket expenses, as permitted by regulation.
  • Written and verbal correspondence with client/representative, community groups, attorneys as needed.
Emergency Room Admitting Registrar, 06/2002 to 2006
John T. Mather Memorial HospitalCity, STATE,
  • Registration of Emergency Room patients: 1st shift: 11:45pm - 7:45am; (Wed-Sun).
  • Initial intake of symptoms, medical history ~ assess severity of situation and communicate to ER Charge Nurse of shift.
  • Receive and process ambulance "Run Sheets" and all accompanying transfer information.
  • Obtain name, address, employer, insurance information, emergency contact information from patient or designated representative.
  • Preparation of ER charts including treatment consents, financials, and HIPPA compliance forms.
  • Order entry of laboratory and/or radiology orders as needed.
  • Overnight admissions of ER patients, Out-patient Procedure registration,.
  • Insurance verification including Medicare/Medicaid and proper coordination of benefits ~ Knowledge of ICD-9 codes necessary.
  • Maintaining a calm and controlled environment in Triage Area and Waiting Room.
Training Coordinator, 03/2000 to 06/2000
North Carolina Partnership For ChildrenCity, STATE,
  • Provide intensive on-the-job training to the partnership's Accounting Coordinators related to technical systems training, fund accounting, cash-basis accounting, chart of accounts, customer service and policies and procedures.
  • Research and resolve outstanding accounting issues with local partnerships and serve as contact/mediator with each partnership's Executive Director.
  • Identify on-going training topics with both the partnerships and NCPC Accounting Coordinators.
  • Assist with the outline and development of training programs.
  • Instrumental in the review and update of the Finance Department Procedures Manual.
  • Review and interpret fiscal year audits and adjusting journal entries by Partnership.
Accounting Coordinator, 03/1998 to 03/2000
North Carolina Partnership For ChildrenCity, STATE,
  • SMART START".
  • Responsible for the fiscal function and oversight of Local Partnerships by county throughout the state.
  • Monitor cash flow of State, local, and private sector grants through MIP - fund accounting system.
  • Review and processing of Accounts Payable invoices by county/partnership ~ Analysis, coding, and entry of cash receipts.
  • Journalize and entry of payroll ~ Reconciliation of Form 941 to the General Ledger.
  • Maintenance of activity budgets, budget amendments and revisions.
  • Reconciliation of bank statements by county/partnership ~ Preparation of NC Sales Tax Claim for Refund Form E-585.
  • Generation of quarterly financial reports to include Trial Balance and detailed General Ledger for State funds as well as local and private grants as required.
  • Assist each partnership in the preparation for annual audit by NC State Auditors' Office.
  • Technical assistance, regional presentations, and on-site partnership training of fiscal staff members.
Education and Training
: Labor Relations, Expected in to SUNY Empire State College - Saratoga Springs, NY
GPA:
Continuing education
: Accounting, Expected in to State University of New York - Farmingdale, NY
GPA:
Activities and Honors

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Resume Overview

School Attended

  • SUNY Empire State College
  • State University of New York

Job Titles Held:

  • Social Services Examiner II
  • Training Supervisor
  • Social Services Examiner I
  • Emergency Room Admitting Registrar
  • Training Coordinator
  • Accounting Coordinator

Degrees

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