Case Management Call Center
Resume:
Mala Vue
Sun Prairie, WI ****0
*******.***@*****.***
Skills:
Experience with BadgerCare Plus, Medicaid, SeniorCare, Medicare, FoodShare, Wisconsin Funeral & Cemetery Aids Program, Wisconsin Well Women Medicaid, GAP Filling,
Fluent in spoken Hmong
Type 40 wpm
Call Center telephone experience
Computer system experience: Microsoft Office, Client Assistance for Reemployment and Economic Support (CARES), ForwardHealth InterChange (IC), Comprehensive Automated Tracking System (CATS), RADAR Onbase, Reynolds & Reynolds, Dentrix, Epic
Work Experience:
Patient Services May 2023 – Present
Access Community Health Centers Madison, WI
Assess and evaluate patient needs in collaboration with clinical staff.
Coordinate and provide case management services to at-risk patients.
Facilitate essential follow-up care for patients.
Track and report activities associated with case management and referrals.
Assist patients in enrolling in government programs such as Food and Medical Assistance and insurance on the Marketplace through the Affordable Care Act.
Administer Access’s sliding fee discount program to support under-insured patients.
Owner, Brow & Lash Specialist June 2018 – Present
Lala Lash & Beauty Madison, WI
Answer phone calls and schedule appointments for salon services.
Greet and check out clients.
Handle cash and credit card payments for services provided.
Provide consultations, permanent make up and eyelash extension service to clients.
Responsible for work area inventory management for necessary items needed at all stations.
Responsible for proper sanitation according to State of Wisconsin protocol and policies.
Medical Records Specialist August 2021- December 2021
Tellurian Madison, WI
Collect patient information and enter in patient file.
Distribute and issue medical files to requesting providers and department.
Ensure all medical records are current, confidential, protected and organized.
Scanned and filed documents for record keeping in all patient accounts.
Complete clerical duties including answering phones, responding to emails, and processing patient admission and discharge records.
Lab Order Associate June 2020 – July 2021
Exact Sciences Madison, WI
Provide outreach to the provider to convey results or they may also contact the providers to complete order clarification activities.
Follow all outlined departmental policies, processes and procedures to fulfill their defined role
●Responsible for the timely entry and resolution of test order issues(s) or physician enrollment issue(s) for Exact Sciences Laboratories to facilitate timely and accurate test ordering.
Conducts all assigned job duties in a timely and productive manner.
Human Services Program Coordinator January 2011 – October 2019
State of Wisconsin, Department of Health Services Madison, WI
Enrollment Management Central Application Processing Operation (EM CAPO)
Process reimbursement requests from Funerals, Crematories, and Cemeteries for the Wisconsin Funeral & Cemetery Aids Program.
Process applications and renewals for SeniorCare Prescription Drug Program, Wisconsin Well Women Medicaid Program.
Determine Medicaid eligibility for hospital coverage for incarcerated inmates, GAP Fill Program, and Foster Care Medicaid for foster care children.
Supported, provided, and communicated policies, procedures, system issues and system fixes to Income Maintenance Supervisors, Consortia leads, CARES Coordinators, advocates and other state agencies.
Researched and responded timely to customer complaints sent from the Governor’s office, the Department of Health Services Secretary’s office, the Division Administrator, and advocacy groups.
Lead and participate in workgroups consisting of Policy, Quality Assurance, Training, and System representative to finalize policy, system business requirements, training and communication schedules for policy and system implementations.
Eligibility Processor Lead August 2010- December 2010 Hewlett Packard Enterprise Services Madison, WI
Supervised and supported team members with federal and state policy questions and clarifications.
Identified and followed-up on questionable or incomplete data supplied by the applicants to obtain missing information and resolve questions.
Processed applications, renewals and changes for BadgerCare Plus Core Plan, FoodShare, and Family Planning Only Services program.
Reviewed escalated cases from team members to ensure accurate benefit issuance.
Lead Customer Service Representative September 2009- August 2010
Automated Health Systems Madison, WI
Supported applicants applying for Wisconsin FoodShare and Healthcare programs.
Determined eligibility through interviews and documentation provided by applicants for BadgerCare Plus Core Plan, FoodShare, and Family Planning Waiver programs.
Reviewed escalated cases from teammates to ensure accurate benefit issuance.
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