Vouchers

Skills

Credentials (0)

Work History

Medicaid Eligibility Specialist Supervisor

Maximus Inc

November 2012 - May 2013

• Training, council, coach, and Supervisor 24 Medicaid Eligibility Specialist, Approved and processed IL Medicaid Redetermination case status.
• Case Management
• Reporting, Track production, approved timecards, interviewed (hiring process), disciplinary actions when needed.
• Process and verified Child Support payments(SDU)
• Verified US Citizenship per (WTPY file) and State residency
• Verification of employment (TWN-The Work Number).
• Verification IDES, PARIS files, and SOS( IL Sec of State)
• Customer service- handled inbound and outbound calls, follow-up request to patients, generated letters.
• Data entry- add income, ssn verification, change/updated patients Info, processed 1300 RE-DE cases daily
• Recommended change, and cancellation of member Medicaid and SNAP benefits.

Billing Assistant Manager/Credentialing Specialist

Physicians Cooperative Community

October 2010 - November 2012

• Training and Supervisor 10 billers, Physicians credentialing for 24 doctors with insurances Commercial, Medicare and Medicaid.
• Physicians CAQH updates and reappointments/recredentialing for participating insurance networks.
• Billing & coding reports, processed paper and electronic claims daily, checked claim status and prepared claim denials.
• Processed deposits, bill insurance claims, post payments and mailing patient statements.
• Biller/follow up- I bill commercial, workmen comp, government Insurance and patients
• Customer service- Answer phone, call patients
• Data entry- add patients charges, send patients to collection, change patients Info. HCFA 1500, 50--80 claims daily
• Batches- check on payment and adjustment. Post payment and adjustment

Medical Biller and Coder

Salt Creek Medical Imaging

April 2011 - May 2011

• Patient registration, electronic filing, scheduling appointment for MRI and CT scan testing, pre-authorization & pre-certifications and patient screening.
• Billing & coding reports, processed paper and electronic claims daily, checked claim status and prepared claim denials.
• Processed deposits, bill insurance claims, post payments and mailing patient statements.

Office Manager

H R Block

2006 - 2011

• Managed, trained, coached, supervised and evaluated staff members.
• Managed store operations and administration.
• Responsible for team development, communications, marketing, sales, profit and labor/cost control management.

Third Party Biller/Collector Specialist

Healthcare Financial Resources

May 2010 - October 2010

• Checked claim status and prepared claim denials.
• Processed deposits, bill insurance claims, post payments and mailing patient statements.
• Biller/follow up- hospital billing commercial, workmen comp, Medicare/Medicaid Insurance and patients
• Customer service- Answer phone, call patients
• Data entry- add patients charges, send patients to collection, change patients Information.
UB94, UB92- about 50- to -80 claim a day
• Batches- check on payment and adjustment. Post payment and adjustment
• Account notation and claim processing

Mental Health Specialist

Allendale Association

2005 - 2006

• Planned and implemented developmentally appropriate activities for children and teens.
• Utilized coping strategies to help patients through procedures.
• Provided therapeutic play interventions within groups and individual.
• Offered support and resources for families.
• Provided diversion activities for in-patients and out-patients.
• Trained volunteers and coordinated schedules and assignments.
• Planned and participated in community awareness events.

Medicaid Special Projects Manager

Maximus Inc

May 2013 - Present

• Supervises and completes work requested through Unscheduled Work Requests that involve immediate attention.
• Manage department performance through motivation, monitoring, and coaching.
• Develops scope of work for special projects.
• Interface and coordinate with operations and account management to ensure specs meet needs of customer and operations.
• Oversees quality control throughout strategic project life cycle
• Develops best practices and tools for project execution and management
• Manages changes in project scope, identifies potential crises and devises contingency plans proactively
• Handle more complex caseload
• Research and resolve service issues and implement solutions.

Qualifications & Certifications

Insurance

Everest College

Information Technology Management

Northwestern College

Robyn Lee Smith

Steger, IL, USA