Verification Specialist Customer Service

Tracey Moses

Edgewood, MD ***** Tel: [c] 267-***-**** Email: adwhlc@r.postjobfree.com

PROFILE

Motivated individual looking for a position where I can integrate skills developed as a team leader. Experience shows an ability to work across different departments throughout the application process provided to schools, libraries, and healthcare providers. Detail-oriented and efficient, able to encourage staff and form strong relationships, with strengths in candidate training, as well as project and time management. Effective at leading all team members to accomplish business goals.

SKILLS

Leadership, Excellent Communication, Decision Making Skills, Organizational/Time Management Skills, Team Lead

WORK EXPERIENCE

Rural Healthcare/Telecom- Team Leader

Maximus - Windsor Mill, MD

Leads team to- Conducts reviews of applications submitted by eligible health care providers for discounts for telecom access, internet access, internal connections, basic maintenance of internal connections, and managed internal broadband services and equipment received for eligibility and determines funding commitments based on RHC procedures.

●Process, as a team- 200-300 applications per month for both rural sectors

●Communicates routine information in a clear and accurate way with internal & external contacts

●Follow established policies and procedures for assigning applications for initial reviews

●Monitored phone activity to ensure each team member was providing good customer service

●

Developed tracking reports for to assess metrics, such as production ratings

●Organized meetings to encourage staff to share ideas, give feedback and trainings for improvement

●Participated in training and development

May 2022-Present

E-Rate Team Leader- Special Compliance

●Responsible for developing, training, and managing a team of representatives to meet daily company goals

●Ensured all policies and procedures were followed by the applicant throughout the lifecycle of the application

●Reviews all case reports, documentation, and statements provided by the application order to identify possible instances of waste, fraud, and abuse

May 2019- May 2022

Program Integrity Assurance- Initial Reviewer 5 mos.

Dec 2018- May 2019

●Conducts complete examination of all forms and supporting documentation by established procedures and program rules that are complex and may have a significant financial impact

●Analyze, research, and interpret application information, as well as submitted documents and contracts to arrive at decisions on eligibility and level of funding using defined operating guidelines

●Communicates with E-Rate applicants, as well as other reviewers to discuss requirements and request additional documentation

Insurance Verification Specialist

Katzen Eye Group - Towson, MD

Jan 2017 – Dec 2018

●Scheduled appointments correctly and followed appropriate guidelines and workflows for 50 providers

●Reviewed the appointment dates, time, location, and providers with an 100% accuracy rating

●Demonstrated efficiency by exceeding departmental goals over an average of 200 calls taken, average of 150 case touches, and average 80% close rate

●Answered questions and offered other relevant and pertinent information, as requested from providers

●Provided a patient-focused oriented service with an extremely positive impression of a great practice

Clinical Data Abstractor

May 2016 –Sept 2016

e4 - West Chester, PA

●Manually migrated data to the new EHR (Epic) under the direction of the Coding & Compliance Supervisor within the 4-month period

●Abstract all active patients from one system to another which equals over 200,000 unique patients

Health IT Project- Internship

March 2016 – April 2016

The Family Practice & Counseling Network - Philadelphia, PA

●Worked with the Director of Quality and the primary care department at FPCN using nominal variables from the Centricity EHR to identify and implement process improvements

●Conducted data review and cleanup for immunization discrepancies, follow up with patient and Philadelphia

Department of Public Health. The ongoing focus is to process improvements within a 4-week timeframe

Abington Memorial Hospital- Summer Co-Op

June 2014 – Aug 2014

Clinical Information Services/Project Manager - Abingdon, PA

●Researched on 5 identified race disparities, as well as people of two or more races

●Developed a powerful presentation to address meaningful use changes to department registrars. After this project, implemented a training manual to assist employees in properly collecting race/ethnicity data.

●Researched collection of data and the importance of race data to provide a solution

●Analyzed and developed a standardized demographic and language data collection for over 36,000 admissions

EDUCATION

Bucks County Community College

Associate of the Arts - Newtown, PA

Aug 2010 – May 2013

●Health Information Technology

●Completed Coursework: Healthcare Quality Improvement, Health Insurance, and Reimbursement, Health Information

Technology, Legal Aspects of Health Information, Pathophysiology and Pharmacology, Medical Coding, Advanced

●Overall GPA 4.0

●Software

Temple University

Aug 2013 – May 2016

Bachelor of Science – Philadelphia, PA

●Health Information Management

●Graduate-level coursework in Data Governance, Data Management, Data Sources, Analytics, Decision Support,

Healthcare Statistics, Research Methods, Consumer Informatics, Enterprise Information Management, Vendor Contract

Management

●Overall GPA 3.6

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