Tammy Shubrick

ad31qo@r.postjobfree.com Bronx, NY **469 917-***-****

SUMMARY

Medicaid Quality Specialist with 6 years of experience with Medicaid claims and audits with a Medical Assistant Certification. Former Receptionist at Ricco & Villanueva Law. My role included approving and auditing timecards, special attention to detail. Within each of my roles,

Education / Certifications

Aquinas High School 6/1999

H.S. Diploma

Stanford- Brown Institute 8/2009

Medical Assistant

Experience

United Bronx Parents - Acacia Network- Health Homes

Medicaid Quality Specialist 1/2018-Present

· Interpreting data and analyzing results using statistical techniques. Data included members within the population of adult, children, HIV+, and Serious Mental Illness (SMI) population. Information included: demographics, quality indicators (preventable screenings[mammogram], medication adherence, Medicaid status (active/non-active/ not compatible)

· Developing and implementing collection systems by using Microsoft Excel to document the information collected an organize it in a way that Program Directors can use information to steer supervisions with care managers based on findings.

· Track quarterly reports that include member hospitalizations, and members in excluded settings such as Detox, Rehab, Hospital, or Nursing Home for billing purposes. Making sure Health Homes forms for regulations are uploaded and documented correctly (Forms: DOH-5055, Comprehensive Assessments, HIPPA, Eligibility & Appropriateness, etc.) in a timely manner.

· Generates quality indicator reports from Medicaid PSYCKES reports and uses this information to identify to Program Director the needed follow-ups.

· Participates in team meetings to address ongoing barriers to care manager audits and requirements for cases to be compliant.

· Completes all required trainings including Cultural Competency, HIPAA, Fraud Waste & Abuse, Annual Human Resources In-service.

Buy Buy Baby

Senior Registry Associate 6/2011-1/2018

· First point of contact at the registry department assisting families with preparing their baby registry.

· Communicate extensive knowledge of product features, benefits, usage and operation of products and services online and in-store

· Create, review, and file all invoice copies, request, and product/service complaints accordingly, while engaging in daily self-audits to ensure compliancy

· Auditing 50+ orders by reviewing all incoming phone/web orders for accuracy, completion and packaging each shift

· Maintaining discrepancies on file while verifying customer demographics, customer credit accounts, outstanding payments, and additional customer information.

· Managing the schedule of deliveries and confirming delivery logistics with 20+ shipping vendors

Ann Taylor Inc.

Sales/Stock Associate 9/2005-3/2009

· Consistently achieved and exceeded all sales quotas for each quarter

· Increased sales by 10% through effective sales as “Top Sale Associate”

· Developed new sales and marketing strategies to increase business by identifying hot commodities being sold and informing the managers. Managers used this information to restock items and re-arrange sales displays suitable to current trends.

Gap Inc.

Stock Associate 9/2002-8/2005

·Worked with the overnight team unloading and processing incoming merchandise before opening store.

·Arranged and set-up incoming products for floor display and window presentation based on sales.

·Self-initiated communication with managers regarding current merchandise inventory as well as forecasted potentials sales for applicable quarter. On-going audit of inventory within the store to inform managers what is required.

Ricco & Villanueva Law

Receptionist 10/1999-11/2001

·Certified payroll in a timely manner on a biweekly basis for all employees.

·Handled accounts payable and accounts receivable collections for ingoing and outgoing transactions/ invoices.

·Organized files, distributed mail, copied, filed, and ordered supplies.

·Conducted office manager tasks that include prepping the training room and training equipment and presentation materials for scheduled events.

·Skills

Microsoft: Word, Outlook, Excel, PowerPoint

Current Software: EmedNY (EPACES- Electronic Provider Assisted Claim Entry System ); Health Commerce System - ( MAPP- Medicaid Analytics Performance Portal); PSYCKES- Psychiatric Services and Clinical Knowledge Enhancement System

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