• Apr 2018 - Present

My tasks as a Federally Qualified Health Center/ Rural Health Center Program Specialist include evaluating programs for compliance with Federal/State guidelines and recommending policy changes. I am responsible for developing and implementing the surveillance of utilization review processes to ensure quality services are being rendered to our Medicaid community. I evaluate current MMIS claims processing systems functionality for FQHC/RHC programs. Within the Department of Community Health I serve as the Subject Matter Expert and organization resource for the FQHC/RHC programs. Show less

• Aug 2016 - Present

My tasks as a Durable Medical Equipment, Orthotics, and Prosthetics program specialist include evaluating programs for compliance with Federal/State guidelines and recommending policy changes. I am responsible for developing and implementing the surveillance of utilization review processes to ensure quality services are being rendered to our Medicaid community. I evaluate current MMIS claims processing systems functionality for Pharmacy, DME, and O&P programs. Within the Department of Community Health I serve as the Subject Matter Expert and organization resource for the DME and O&P programs. Show less

Medical Claims Representative

• Sep 2015 - Sep 2016

• Verify all claims and charges for medical providers. • Manage all claim files for residual periods and ensure accuracy in same and monitor all payment and denial of claims and coordinate with manager for same. • Handle claims for multiple states and Medicaid plans (Ex: GA, KS, MO, NH, MA, LA, MS) • Verify all claims and charges for medical providers. • Manage all claim files for residual periods and ensure accuracy in same and monitor all payment and denial of claims and coordinate with manager for same. • Handle claims for multiple states and Medicaid plans (Ex: GA, KS, MO, NH, MA, LA, MS)

Community Outreach Specialist

• Aug 2015 - Jan 2016

•Promoted HIV/AIDS prevention and awareness in the City of Petersburg, Virginia by providing local organizations and businesses with free contraceptives, such as condoms, to distribute to the community •Assisted with HIV/AIDS testing at the Men’s Health Clinic at the Petersburg Health Department. •Received 100 credit hours. •Promoted HIV/AIDS prevention and awareness in the City of Petersburg, Virginia by providing local organizations and businesses with free contraceptives, such as condoms, to distribute to the community •Assisted with HIV/AIDS testing at the Men’s Health Clinic at the Petersburg Health Department. •Received 100 credit hours.

Medical Call Center Representative

• Jan 2015 - Jul 2015

•Provide health education-related telephone customer service to patients of a Health Resources Services Administration (HRSA)-designated, Federally Qualified Community Health Center. •Provide prompt, polite and effective customer service to each caller by addressing the needs identified during each incoming telephone call. •Schedule appointments, leave messages for providers and other staff members, respond to general inquiries and otherwise provide solutions to callers’ questions and concerns. Show less

Chart Auditor

• Oct 2014 - Dec 2014

•Maintained the accuracy of medical records through regular updates, and ensuring the records were easily and readily accessible by authorized medical personnel. •Verified each record for proper identification of the patient, documentation of diagnosis, and explanation of treatment, as well as reported outcomes. •Maintained the accuracy of medical records through regular updates, and ensuring the records were easily and readily accessible by authorized medical personnel. •Verified each record for proper identification of the patient, documentation of diagnosis, and explanation of treatment, as well as reported outcomes.

Filing Assistant

• Oct 2010 - May 2011

•Ensured that each personnel file contained all required employment documentation and forms. Maintained files daily as required by the Human Resources team. •Ensured each Member file contained up-to-date information for organizational record keeping purposes. Prepared aged files for archiving and disposal. •Completed general office tasks including interoffice communications, faxing, copying, and general filing. •Ensured that each personnel file contained all required employment documentation and forms. Maintained files daily as required by the Human Resources team. •Ensured each Member file contained up-to-date information for organizational record keeping purposes. Prepared aged files for archiving and disposal. •Completed general office tasks including interoffice communications, faxing, copying, and general filing.