Exceptional employee talented at medical and legal issues. Motivated by success to produce not only high numbers of claims but extremely accurate claims processing.
Authorization Quality Review Specialist
Veteran Service RepresentativeOct 2011 to Current VA Regional Office － Muskogee, OK
Mastered the Core, Express, Special Operations, and Appeals team as a VSR on each
Experienced on Post VSR work as well, as it's needed for Appeals to include gapping in ADL and PCGL programs expertly
Excel at retirement, severance, separation, and drill pay
Provided training on Exam Track 2, CAATS, and Military Sexual Trauma screening
Screen service treatment records for diagnosis of or symptoms of claimed medical conditions
Review of additional medical evidence for current diagnosis or symptoms of claimed conditions
Request evidence such as service treatment records from federal facilities, private medical records, social security records and VA medical facilities
Develop for or request all evidence needed to properly process claims Create letters to provide information to the veterans for what the VA needs to process their claim effectively.
Create letters and emails requesting information from outside parties to aid in the veterans claim to include Records Management Center, Personnel Information Exchange System, and private doctors
Successfully work under strict time constraints for priority cases especially on the special operations team as the majority of these cases are priority as in homeless, terminal, or hardship claims
Ability to manage workload based on priority and emergence of claims as in hardship, homeless, terminal, and Fully Developed Claims
Process claims that fall under specialized legislation that also require the knowledge and ability to research legal aids like the 38 C.F.R
Successfully work highly sensitive claims that are looked at on a national level
Communicate with co-workers and veterans alike with mutual respect
Served for 3 years on the Equal Employment Opportunity board at VA
Met with my immediate supervisor and the Veteran Service Center Manager for concerns involving employee production and our medical screening methods.
As a result of that meeting I worked directly with a small group of Veteran Service Representatives and Rating Veteran Service Representatives to develop a plan of action to not only speed up our screening process but to further improve our accuracy
Communicate effectively with co-workers and veterans on a daily basis Assist Jr. and other Sr. Veteran Service Representatives with development and or screening questions daily via email, IM, or in person
Military Sexual Trauma Claim Coordinator for our Regional Office for 1 year until transferring to Appeals in which I am still the back up
Empathetic toward other employees and veterans situations
Access and utilize multiple medical websites and aides such as Medical EPSS (database of medical diagnosis that pertain to the rating schedule), Google, WebMD, and the Rating Schedule Access and utilize multiple legal websites and aides for clarifications and accurate decisions such as 38CFR (Rating Schedule), M21-1MR, Fast Letters, and Training Letters.
Claims AssistantJun 2009 to Sep 2011 VA Regional Office － Muskogee, OK
Worked in the File Bank, Privacy Act, Education, Triage, and the Front Office all in a little over a 2 year span in order to accommodate the VA's needs and successfully master each position
Input claims into VA systems- Map-D, SHARE, and VACOLS
Maintained locked files and locked file reports and accounting of employees from other stations and sometimes from our own station under strict lock and key.
Kept accurate logs of the locked files movement
As the locked file clerk I followed VA regulations as to how they were maintained and they stayed in a constant state of readiness for surprise audits
Processed education payments to veterans Arranged travel for all of our managers and employees
Completed expense reports for all managers and employees
Ordered supplies for the entire Veteran's Service Center
Processed time cards for 300+ employees with mandatory overtime
Encrypted every employee, manager, and corporate emails personally.
Maintained the Front Office work normally completed by 3 secretaries, alone and successfully
Logged 300+ employees overtime hours
Submitted reports on overtime, travel, and locked files
Worked with Management and Supervisors on special projects like Performance Appraisals
Communicated with all employees and management via email for their needs or special requests that the Front Office provided.
Associate of Arts, General Studies2005Tyler Junior College － TXGeneral Studies
Bachelor of Science, Psychology2009Northeastern State University － Tahlequah, OKPsychology
Court Appointed Special Advocate (CASA) for children who have been removed from their homes
Gather information and write formal reports and recommendations to the Judge
Referee Assignor for Muskogee Soccer Club
Schedule referees to games and pay referees after their games
Log all information on money paid out and report to the club treasurer
Accurately type 62 wpm
Strong verbal communication
Empathetic to veterans and
Analytical skills to include the ability
to identify claims/issues, interpret law
and apply as needed