Service Nursing Home

C H IZE L L GARV I N

**** ***** ***., ***. ** • B rooklyn, NY 11230 • 347-***-**** • 917-***-****

*********@*******.***

OBJECT IVE: To secure a management position in the Human Service Profession, where I can utilize acquired

skills in a challenging environment.

RELATED EXPER IENCE: Christ Temple of Love Church, Community Center, Brooklyn, NY

01/11 – 02/13 Social Service Outreach Counselor

• Interview, assist clients and families with processing Public Assistance, Food Stamps,

Social Security, Medicaid, Child Health Plus, Family Health Plus, PCAP, applications and

other government subsidized programs. Educate clients on the guidelines and required

documentation to facilitate applications. Assist clients with obtaining appropriate, required

i nformation such as financial and personal data to meet entitlement.

• Advocate, act as liaison for clients at city fair hearings, face to face interviews and local

social service offices and business institutions.

• Assist with enrollment, disenrollment, of HMO, PCP and Medicare part D plans. Assist

clients needing Nursing Home, Home Health Aide, Adult Protective Service, and Long term

care programs.

• Accompany the disabled and elderly to clinic, and doctor visits. Conduct home visit

assessments to assist with ordering medical surgical supplies, medications, monthly

banking, and bill payment.

• Organize all church, and community functions.

• Organize group substance abuse meetings and assist in guidance to detox, and homeless

shelters.

07/96 – 07/10 Visiting Nurse Service of New York Home Care, New York, NY

Patient Accounts: Supervisor Financial Investigators

• Supervised support staff 13. Interview screen patients for Medicaid entitlement, submission

p rocess of Medicaid, Family Health Plus, Child Health Plus, Hospice, Lombardi NYSARC (pool

t rust), Nursing home, Home Health Aide applications and Medicaid recertification

renewals.

• Educate patients on required documentation and regulations on applying for Medical

assistance. Conduct means test investigation into patient’s income, resources and assets for

eligibility.

• Conduct home visits to access and assist with gathering documentation information.

Advocate act as liaison to retrieve financial, personal data, attend fair hearings, conferences and

local social service offices for patients.

• Maintained daily self-pay, Medicaid denial, Medicaid pending report logs to investigate

d iscrepancies, make corrections, capture patients needing medical coverage or secondary

i nsurance for medical bills and services rendered.

• Maintained monthly claims, billing and collections, verification, investigation on all

commercial, HMO, PCP plans, and obtain authorization.

• Handled all case processing on MEMS, MEDE, Emedeon, AIM scanner, E paces computer

systems.

• Accomplishments: Cut agency’s unbilled (non collected) revenue by 80% bringing in 4

m illion dollars agency wide in a 6 month period. Annual selfpay, Medicaid surplus collected

revenue ranged from $100,000 to as much as $150,000 in fiscal year. Medicaid application

submissions averaged 7000 yearly, case approvals at 99% and denial, deferrals at 1% yearly.

• Develop new workflows, policies and procedures resulting in faster revenue collections

for the company.

• Designed departmental training, training materials and manuals.

06/95 – 12/95 Kingsbrook Jewish Medical Center, Rutland Nursing Home, Brooklyn, NY

P atient Accounts: Supervisor Financial Investigators

• Supervised Staff of 9. Interview, screened patients, and families for Medicaid

entitlement. Submission and processing of all hospital, Nursing Home, and Home Health

A ide applications and recertification renewals

• Educate applicants on required documentation and regulations of filling. Verification on

a ll commercial insurances, HMO, PCP plans.

• Eagle computer system used for all data entry, personal data, insurance update, case

t racking, demographic posting. Daily review of Medicaid pending, denial, report logs to

correct errors, catch discrepancies and capture patients needing insurance, HMO, PCP

authorizations.

• Admit and discharge patients. Distribution and processing clinic cards. Trained all staff,

conducted caseload staff reviews, and statistical reporting

SKILLS: Eagle System, CARES, WMS, MEMS, MEDE, Emedeon, E paces, EMEVS, AIM Imaging

Scanner, Omnipro, Trainer, Counselor, Outlook, Word, Access, Minor Excel, Supervisory and

M anagerial background. Social Service knowledgeable, Medicaid inpatient, Outpatient

k nowledge, Medicaid Certified.

EDUCAT ION: New York, City Technical College

A.A.S., Human Services, 1985

R EFERENCES: Furnished upon request.

Contact this candidate