Center Representative Call

Lucille K. Alford

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

****–B Pats Place • Tallahassee, F l orida 32308 • ( 850) 590–0715 PROFILE

• Versatile professional with a foundation in Nursing and 20+ years of experience in governmental, healthcare, and nonprofit settings leveraging critical thinking skills to analyze all factors, assess needs, devise high–value solutions, and facilitate communications with internal and external constituents to bridge differences, build cooperation, protect confidentiality, and align efforts with organizational priorities to attain performance goals KEY SKILLS

• Assessment of Facts • Case Management • Clinical Care Protocols • Communications

• Compliance Monitoring • Customer Service • Documentation & Reporting • Interviews & Investigations

• Medical Terminology • Quality Control • Records Management • Relationship Building

• Research & Analysis • Team Collaborations • Training & Development • Workflow Planning EXPERIENCE

Support Coordinator-Grant-funded Program Detection and Mitigation Covid-19 in the Homeless Population

Bureau of Epidemiology

Department of Health, State of Florida (DOH), Tallahassee, Florida, December 2021-present Coordinator job duties include:

• Initiating/developing/sustaining relationships across the State of Florida with 27 Continuum of Care entities

• Establish or support formal partnerships between health departments, homeless service providers, health care providers, and other relevant community organizations to respond to Covid-19 within this population

• Coordinate resources, develop strategies and support relationships to mitigate Covid-19 in populations experiencing homelessness

• Implement regular Covid-19 screening and diagnostic testing for homeless service site clients and site staff, people experiencing unsheltered homelessness, and outreach staff Contract Disease Data Specialist

Bureau of Epidemiology

Department of Health, State of Florida (DOH), Tallahassee, Florida, December 2020-December 2021 Function as data entry professional to review and enter laboratory testing results per SARS CoV-2 Pandemic:

• Adherence to Agency protocols to ensure accuracy when entering any amount of data so information is readily understood by subsequent reviewers

• Testing results reviewed/entered entailed receipt as hard copy, to portal, to website, or as electronic record (ELR)

• High level attention to detail all types Covid-19 testing and results, originating in-state and out-of-state testing sites, facilities, labs

• Results received varied from single result files to multiple results per file; required skills/ ability to accurately divide large-to-very large files by split/collate/organize data to allow system entry as single files

• Maintain and exceed daily work quotas/standards

Medical Disability Examiner

DIVISION OF DISABILITY DETERMINATIONS (DDD),

DEPARTMENT OF HEALTH, STATE OF FLORIDA (DOH), Tallahassee, Florida, April 2010 — October 2020

• Function as a Case Manager for the Division of Disability Determinations in the department that processes and adjudicates claims to determine the medical eligibility of applicants to receive benefits and assesses the continuing eligibility of existing beneficiaries under the provisions of federally–funded programs:

• Completed an extensive training program to refresh knowledge of human anatomy, physiology, medical terminology, clinical protocols, and program requirements to optimize quality in reviewing patient records, extracting facts from multiple sources, and interpreting data to present evidence–based conclusions

• Apply in–depth knowledge of the Social Security Disability Insurance and Supplemental Security Income Programs to ensure compliance with federal and state statutes, regulations, procedures, and policies in order Lucille K. Alford

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to deter fraud, optimize cost efficiency, and sustain quality customer service standards in developing and guiding cases through the technicalities of a process leading to the approval or denial of financial benefits

• Utilize reference materials in electronic and paper formats (including EMR) and resolve conflicting data to ensure cases are properly adjudicated according to the policies and procedures of the DDD and the SSA

• Meet exacting performance goals mandated by federal and state agencies, accurately condensing large amounts of information into easily utilized formats that can be readily understood by all subsequent reviewers to justify determinations in cases that involve medical, behavioral, and/or vocational components

• Maintain high standards of excellence: (1) sustaining an exceptionally low QA return rate of cases returned by the Quality Assessment for mitigation of technical issues, (2) containing costs to 25% under state average through skill in minimizing expenses in securing materials such as medical records and minimizing expenses of outside consultative exams, and (3) maintaining an overall accuracy rate of 98% to 100%

• Receive claims filed at Social Security Administration (SSA) field offices across Florida, and manage a workload 120 active cases with turnaround times that vary from 45 to 120 days based on individual complexity, fast–track compassionate allowance cases for terminal claimants, and meet cost, quality, and time goals in processing applications and re–considerations for benefits for children and adults

• Serve the needs of a diverse claimant population that spans the social, economic, educational, and cultural spectrum, which includes tracing locations of indigent claimants with no permanent residence and surmounting communication barriers to attain cooperation and reach unbiased determinations

• Manage phone and written communications with claimants, primary care physicians, psychologists, speech therapists, other allied health professionals, schools, attorneys, and various public agencies to gather data involving age, medical, mental health, education, occupational, and socioeconomic factors

• Demonstrate the ability to perform assigned duties under high–stress situations and control complex and sensitive conversations to secure required information from clients and a diversity of third–parties Page 1 of 3

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• Review medical records, facilitate interviews, conduct database research to gather information, and forward cases for the Scheduling Unit to arrange for physical, speech, hearing, mental health, and other clinical assessments to reach determinations supported by medical opinions, expedite closures, and transmit cases for the SSA to review and notify applicants of approvals or denials

• Acted as a single decision maker at the initial case level until a policy change in November 2018

• Distinguished for exceptional dedication to service, earning recognition as a recipient of a Challenge Medal for volunteering to help staff the hotline at the state’s Emergency Operations Center to communicate with responders and citizens during disaster recovery after Hurricane Irma Regulatory Analyst I

PUBLIC SERVICE COMMISSION, STATE OF FLORIDA, Tallahassee, Florida, October 2002 — April 2010

• Worked with quasi–legislative judicial body whose mission was to balance the interests of industry and consumers and foster healthy competition in overseeing investor–owned electric, gas, telecommunications, and wastewater providers to ensure reliability, quality, and safety in delivering utility services at fair prices:

• Staffed a high–volume call center, applying a current knowledge of changing policies, procedures, laws, and regulations, industry tariffs, rate structures, fuel charges, and knowledge of PSC’s hearings and proceedings to answer inquiries relating to a diversity of regulated and non–regulated issues

• Efficiently managed a workload of up to 30 calls on a standard work day (which could increase to a volume 60+ calls daily in the aftermath of emergencies and disasters such as hurricanes)

• Entered details of consumer concerns and complaints into the database to document communications, justify actions, provide a means to measure qualitative and quantitative performance, and serve as a basis to expedite decision making by leadership and support interests in legislative matters

• Displayed the ability to quickly instill trust, diplomatically deescalate attitudes, gather pertinent details, and separate fact from emotion to assess the validity of complaints and determine proper jurisdiction

• Conducted investigations and facilitated communications between consumers and executive offices of providers to research issues, broker compromises, and resolve minor complaints, or transmit more complex cases for consideration, determination, and action by senior leadership authorities

• Worked in crisis mode to aid constituents in times of storms and power outages that impacted the welfare of medically fragile citizens dependent on oxygen, refrigerated medications, and electrical devices, which included accountability for assessing threat levels to dispatch EMS to deliver patient care and contact hotlines to intervene with unstable persons at risk harming themselves or others Call Center Representative

DEPARTMENT OF INSURANCE (now DEPARTMENT OF FINANCIAL SERVICES), STATE OF FLORIDA, Tallahassee, Florida, May 2001 — October 2002

• Provided front–line customer service staffing a high–volume call center as s first point of contact to field inquiries to the agency charged with overseeing regulatory, compliance, and enforcement matters governing the business of insurance and providing state–wide monitoring of insurance industry activities:

• Mastered a complexity of policies, procedures, laws, and regulations to ensure compliance and maintain accuracy, timeliness, and completeness in providing advice to Florida–licensed agents and adjusters

• Served as a liaison to manage communications with agents and adjusters who were physically based in Florida and throughout the United States to educate them to the state’s licensure requirements

• Applied a current working knowledge of agency protocols relating to licensures to represent, sell, and service life/health and property/casualty lines, explain processes to convert various types of insurance licenses (and subspecialties), and verify status of their Continuing Professional Education hours

• Projected professionalism, patience, and a commitment to excellence functioning as a representative of the agency with the goal to deliver quality service and sustain a positive public image for the agency Lucille K. Alford

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OTHER PERTINENT EXPERIENCE

• 15+ years of clinical, administrative, and volunteer experiences working with a diversity of healthcare and community–based nonprofit organizations to deliver services and programs:

• Held Nursing positions working as a Charge Nurse, Head Nurse, Team Leader, and Staff Nurse in Behavioral Health, Medical/Surgical, and Cardiac Care Units delivering direct care to patients at six different medical facilities serving communities in Florida and Massachusetts

• Served as Adjunct Faculty of Fisher Junior College (Hyannis, Massachusetts) working with the Office of Job Partnerships in a collaboration to fund a Medical Secretarial Certificate Program; taught classes in Medical Terminology

• Served as a Nurse Consultant – Clinical Coordinator to coordinate and oversee the delivery of services to multiple adults diagnosed with profound developmental and physical disabilities while working with Community Systems, Inc. (Cotuit, Massachusetts)

• Participated in Community Outreach initiatives of various healthcare facilities, and personally contributed time and expertise as a Community Volunteer helping to ensure quality in planning and executing fundraisers, special events, and services for underserved, at–risk populations EDUCATION

BOSTON UNIVERSITY, Boston, Massachusetts

Bachelor of Science in Nursing

LICENSES & CERTIFICATIONS

• Registered Nurse, Licensure Status: Currently Inactive COMPUTER SKILLS

• Ability to quickly learn and efficiently apply knowledge of new technologies and proprietary software

• Experienced in operating Windows–based PCs using MS Word, Outlook, and Internet programs

• Skilled in using mobile devices (smartphones, laptops, and tablets) to manage virtual communications

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