Experience

Devoted Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Community guide

  • Oct 2022 - Present

  Assist Medicare advantage members with applying for financial assistance for various community programs. Assist members during the application process until a decision had been made through respective agencies such as Medicaid, SNAP, Prescription Assistance programs, and LIS. Assist members with annual reviews and / or redirecting members to resources that are beneficial to their well being. Assist Medicare advantage members with applying for financial assistance for various community programs. Assist members during the application process until a decision had been made through respective agencies such as Medicaid, SNAP, Prescription Assistance programs, and LIS. Assist members with annual reviews and / or redirecting members to resources that are beneficial to their well being.



Alabama Medicaid Agency

• Insurance
• 100 - 200 Employee

• Medicaid Eligibility Specialist

  • May 2020 - Oct 2021



McKesson

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Reimbursement Specialist

  • Feb 2019 - Feb 2020

  • Gathers and reviews patient billing and medical information to determine if patients’ diagnoses qualify and products requjired are covered under Medicare part B benefits. • Receive orders by phone or electronic means – obtaining all information necessary to process the order. • Contact each new customer to inform them of the order. • Follow Insurance guidelines when preparing the order to be processed • Contact Healthcare Providers to obtain any additional and/or supporting… Show more • Gathers and reviews patient billing and medical information to determine if patients’ diagnoses qualify and products requjired are covered under Medicare part B benefits. • Receive orders by phone or electronic means – obtaining all information necessary to process the order. • Contact each new customer to inform them of the order. • Follow Insurance guidelines when preparing the order to be processed • Contact Healthcare Providers to obtain any additional and/or supporting documentation to complete orders. • Communicate any order delays to patients and/or referrals when the situation arises. Show less • Gathers and reviews patient billing and medical information to determine if patients’ diagnoses qualify and products requjired are covered under Medicare part B benefits. • Receive orders by phone or electronic means – obtaining all information necessary to process the order. • Contact each new customer to inform them of the order. • Follow Insurance guidelines when preparing the order to be processed • Contact Healthcare Providers to obtain any additional and/or supporting… Show more • Gathers and reviews patient billing and medical information to determine if patients’ diagnoses qualify and products requjired are covered under Medicare part B benefits. • Receive orders by phone or electronic means – obtaining all information necessary to process the order. • Contact each new customer to inform them of the order. • Follow Insurance guidelines when preparing the order to be processed • Contact Healthcare Providers to obtain any additional and/or supporting documentation to complete orders. • Communicate any order delays to patients and/or referrals when the situation arises. Show less



Alabama Medicaid Agency

• Insurance
• 100 - 200 Employee

• Medicaid Eligibility Specialist, Senior

  • Oct 2017 - Feb 2019

  My responsibilities include managing a caseload for elderly and disabled individuals to assist them with obtaining Medicaid eligibility. I reimbursed Medicaid patients travel expenses that were incurred while attending doctor appointments and hospital visits.

• Senior Medicaid Eligibility Specialist

  • Oct 2013 - Oct 2017

  -Reviews applications received for completeness/accuracy, residency, and determines if any additional information is necessary to process the application. -Interviews client/ sponsor/ appointment of representative in order to obtain all of the necessary information needed to complete the application and make an eligibility determination timely. -Makes initial financial eligibility determinations utilizing documentation and information from the application and other sources .… Show more -Reviews applications received for completeness/accuracy, residency, and determines if any additional information is necessary to process the application. -Interviews client/ sponsor/ appointment of representative in order to obtain all of the necessary information needed to complete the application and make an eligibility determination timely. -Makes initial financial eligibility determinations utilizing documentation and information from the application and other sources . Calculates budget and accounting for transfers and liability amounts to the nursing home. -Determines value of real property by researching values in order to evaluate property ownership and estate assets. This includes review of wills, liens, court orders, tax appraisals, mortgages, life estate, and other records that provide information on real property. - Verifies income, earned and unearned by reviewing various sources from wage information. - Communicates with applicants/ sponsors , nursing homes, and other agencies information about Medicaid financial eligibility via phone, written communication, and face to face at meetings, conferences, and fair hearings. - Verify liquid assets and other types of resources including personal property and burial/ life insurance by reviewing statements pertaining to bank accounts in order to determine the value of liquid assets.



Blue Cross Blue Shield of Georgia

• Midland, Georgia

• Customer Care Associate

  • Jul 2013 - Oct 2013

  • Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Analyzes problems and provides information/solutions. • Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. • Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various… Show more • Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Analyzes problems and provides information/solutions. • Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. • Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner Show less • Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Analyzes problems and provides information/solutions. • Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. • Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various… Show more • Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Analyzes problems and provides information/solutions. • Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. • Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner Show less



Alabama Department of Rehabilitation Services

• United States
• Consumer Services
• 200 - 300 Employee

• Personnel Assistant

  • Oct 2012 - Apr 2013

  • Process leave requests as taken by employees • Process Family Medical Leave Act requests • Receive and process performance appraisals from statewide offices for the department and send them to the State Personnel’s office in a timely manner. • Process leave requests as taken by employees • Process Family Medical Leave Act requests • Receive and process performance appraisals from statewide offices for the department and send them to the State Personnel’s office in a timely manner.



Auburn University Office of Development

• Auburn, Alabama Area

• Student Caller/ Advocate

  • Mar 2009 - Dec 2011

  • Interact with alumni/friends from every College and department at Auburn University over the phone • Encourage previous donors as well as not-yet-donors to contribute monetary gifts to Auburn University for the benefit of undergraduate /graduate students • Have raised over $40,000 for the university single-handedly • Interact with alumni/friends from every College and department at Auburn University over the phone • Encourage previous donors as well as not-yet-donors to contribute monetary gifts to Auburn University for the benefit of undergraduate /graduate students • Have raised over $40,000 for the university single-handedly