MassHealth Eligibility Specialist

• Jul 2023 - Present

Provider Enrollment Specialist

• Apr 2023 - Jul 2023

Data Analyst

• Aug 2022 - Jul 2023

Ran reports that produced raw-data and with the use of excel and company software I would turn that data into useful information. Which led the company saving money from unnecessary billing to patients. This is involved personally developing in-depth and interactive spreadsheets that were very user-friendly. With the above said data and reports I ran, it was also my responsibility to e-mail all the Case Managers in regard to any discrepancies that I have found when working on my reports. Advising the Case Managers (CM) to correct said discrepancy, following if needed (i.e., the CM not correcting the issue). These duties are a blend of supervision and data analysis. To achieve these responsibilities, I had to know how to not only know how to the Case Managers jobs, but my job as well. It is a newly created position with minimal infrastructure in-place as far as learning the job. So, self-initiative skillsets are mandatory to be successful in this position. To sum up, the following are some of the duties and skillsets I utilized as a Data Analytics Specialist. • Strong Attention to Detail, Discipline, and Drive. • Requires knowledge of how the Homecare Dept's Case Managers Operate on a Daily Basis. • Running Multiple Reports and importing the data into Microsoft Excel. • Taking the raw data from the Excel reports and creating dynamic spreadsheets with useful and valuable information. • Tracking Case Managers Discrepancies, and multiple e-mails may apply if correction is not made. • Streamlining Processes / Increasing Production through Innovation • Software / Hardware Savy – quickly learn and adapt to new software and hardware • Proficiency with Excel and other Microsoft Office Software •Strong written and verbal skills • Leadership qualities and a team player • Experienced Show less

Provider Enrollment Clerk II

• Sep 2014 - Jan 2023

Part A/B Medicare Enrollment • Process and complete incoming applications for Physicians/Non-Physicians that are applying for Medicare and for Providers to be able to see Medicare Patients. • Identifying provider types, reviewing all information on applications, applying corrections where needed, and checking that all required documents have been submitted. • Communicated with providers to answer and assist in the application process/completion, and entered Provider information into multiple system databases Show less

Claims Specialist

• May 2019 - May 2022

I was transferred from NHIC (Peraton) to Anthem, my years-of-service was transferrable due to the contract I was assigned.• Processes any incoming Claims from Medicare Patients/Providers for billing purposes. These claims would then be either approved or denied based on what was provided on said claims. Ensuring all claims are adhering to Medical Laws and Regulations.• Strong Knowledge of Medicare regulations, HIPAA laws, Medical Terminology • These Medicare Claims differ from claim to claim, and subsequently have different requirements per application type. Show less

Provider Enrollment Clerk I

• Sep 2014 - May 2019

• Process and complete incoming applications for Physicians/Non-Physicians that are applying for Medicare and for Providers to be able to see Medicare Patients. • Identifying provider types, reviewing all information on applications, applying corrections where needed, and checking that all required documents have been submitted.• Communicated with providers to answer and assist in the application process/completion, and entered Provider information into multiple system databases

Database Specialist

• Sep 2013 - Sep 2014

Advertising/Marketing, Website Developer, Systems Maintenance • Assisted with the creation (and periodically updating) of brochures, catalogs, promotions, etc. • Tracked inventory, adjusted pricing, analyzed margins via Microsoft Excel. • Responsible for keeping company website up-to-date on a weekly basis with new products, product descriptions, pricing, promotional offers, etc. • Improved in-house operating systems by reducing file sizes, image editing, and updating the aesthetic of the imagery to increase the processing speed of said website. Show less

Private Aircraft Fueling Logistics

• Nov 2008 - Aug 2013

Provided fueling arrangements for high-profile client’s private aircraft. Determining possible fuel stops that are within in range of their flight-paths. Providing fueling arrangements for departure and arrival. Working directly with pilots, Private Hanger Management, and Client Representatives. Attention to detail with strong organizational skills, and clear and concise communication skills. In addition to arranging fuel, we also negotiated fuel prices with these frequented airports or “Fixed Base Operations (FBO)”. Show less