Customer Service M A
Resume:
Shanequa Ellis
*.*********@*****.***
Professional Summary:
Motivated healthcare professional with over 10 years experience in the customer service and healthcare industry. Effectively communicate via email, writing and verbal. Experience
HMG Healthcare LLC 09/2020-10/2023
Corporate Medicaid Pending Specialist
● Subject matter expert for 16 long-term care facilities and to over ninety LTC Medicaid accounts.
● Effectively explain benefits, requirements and provide professional insight to staff, residents and family members.
● Collaborate with cross-functional teams to understand customer needs and deliver tailored solutions.
● Review financial and assets documents in details in order to ensure compliance with State and Federal laws
● Accurately document case records through Point Click Care, PCC and other electronic monitoring systems.
● Thoroughly research denials or complaints and troubleshoot complex files resulting in the recovery of over $1M funds in 10 months.
● Follow through with applicant and authorized representatives to obtain and complete information within strict time frames
Texas Health and Human Services Commission (Houston, TX) OWP-Medical Supervisor 12/2018-12/2019
● Managed and monitored workload to ensure effective and timely client services for multiple assigned facilities.
● Increased productivity by establishing unit goals and objectives while developing and approving schedules, priorities, and standards to oversee program evaluation activities.
● Planned, implemented, coordinated, and monitored service delivery at all assigned locations.
● Assigned and supervised the work of assigned staff in assigned locations including clerks, workers and leads.
● Prepared management reports, analyses, productivity studies, and other correspondence related to program activities.
● Implemented program guidelines, procedures, policies, rules, and regulations; and monitored compliance with policies and procedures.
● Monitored absenteeism levels and worked with staff and management to address issues and improve productivity
Assistant Supervisor 5/2016 - 12/2018
● Prepared daily, weekly and monthly reports for supervisor and other management staff using software such as Excel, Outlook, Word and Powerpoint
● Administered all parts of the hiring process such as scheduling, testing and interviewing prospective candidates resulting in top candidate selection
● Assessed the knowledge skills and abilities of new and current employees and provided training and development suggestions to manager and director
● Provided oversight of innovation & vision policies that shape agency growth.
● Reviewed, monitored and assisted other workers in order to ensure eligibility services are rendered correctly
● Solved client and legislative complaints and send emails to appropriate stakeholders 1
Shanequa Ellis
*.*********@*****.***
● Performed duties of MES I & II as necessary to ensure timelines and agency mission are met
● Volunteered for special projects and assignments, when appropriate to expand knowledge and further the agency mission/vision
● Maintained a high level of confidentiality and ethics and represent the company with moral and integrity at all times
Medical Eligibility Specialist I & II 9/2012 - 5/2016
● Maintained policy and procedural knowledge regarding state funded program benefits, eligibility and HIPPA for clients
● Effectively retrieved information, including performing cold calls to clients and external agencies
● Conducted interviews with clients, documented information, gathered data, and verified case data to ensure accuracy of eligibility for programs and services provided by HHSC
● Increased unit's timeliness by independently planning, organizing and prioritizing daily tasks
● Analyzed data provided by third party interfaces such as Data Broker, SOLQ and BVS Department of Health Services, (Milwaukee, WI) 10/2011 - 2/2012 Income Maintenance Specialist I
● Maintain a regular and predictable work schedule
● Interview clients and obtained income and resources information to determine benefit eligibility
● Managed ongoing caseload to certify appropriate continuation of services Professional Development
Google Data Analytics (Coursera) Expected Completion: Jan 2024 Introduction to Data Analytics (Coursera) 9/2023 - 9/2023 Business Operation & Support Intern (Health & Human Services) 9/2013 - 7/2016 Education
American Intercontinental University (Houston, TX) 7/2014 - 9/2015 Master of Business Administration in Human Resources Management University of Wisconsin (Madison, WI) 9/2005 - 12/2009 Bachelor of Arts - Social Welfare and Legal Studies 2
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