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Resume:
LESLIE E. GRIFFIN
Baltimore. MD *****
***************@*****.***
* ***** ** ******** ******* and 3+ years in healthcare/physician services which can be applied in any work setting.
SKILLS
• Customer Service
• Healthcare Enrollment/Credentialing
• Medical Terminology
• Ability to Multitask
• Administrative/Office Support
• Data Entry
• Payment Management/Handling/Processing
• Technical Support
EXPERIENCE
Sep 2024-Present
Maryland Dept of Health (Contractor for Priority One), Eligibility Determination Division, Baltimore, MD
Medical Care Program Associate II
• Coordinates with Medicaid recipients and internal team members to verify required documentation for Maryland, Medicaid, Employed Individuals with Disabilities program.
• Provides customer service through phone/email/in person (50-75 calls per day) to provide any requested information regarding their enrollment process. Discuss application/documentation requirements with applicants/recipients/authorized representatives.
• Evaluates and determines Medicaid eligibility using BEACON and MMIS systems, ensuring compliance with HIPAA guidelines, federal and State regulations. • Conducts comprehensive case reviews and process redetermination applications using E&E, AVS and A/R platforms to verify applicant information and maintain data integrity.
• Streamlines application processing through effective coordination with healthcare physicians and internal teams to enhance workflow efficiency.
• Software/platforms used: BEACON, MMIS, AVS, A/R, Google systems (i.e. Teams, Gmail, Sheets) o Plaforms used: BEACON, MMIS, AVS, A/R, Google systems
(i.e. Teams, Gmail, Sheets)
February 2024- July 2024
Loomis Armored, Nottingham, MD
Cash Management Services Teller
• Implemented systematic error detection protocols, documenting currency discrepancies and coordinating with management for swift resolutions.
• Optimized deposit processing workflows to maintain consistent green status metrics while ensuring compliance with security protocols.
• Reported any monetary errors to managers and/or shift leads (i.e. difference in pre counted vs. post counted, counterfeit bills, damaged currency, etc.) February 2023- October 2023
Activus Connect, Baltimore, MD
Remote Content Moderator
• Reviewed website content, including text and images, to ensure that it follows company guidelines.
• Compared hundreds of different responses to general AI questions daily. o Exceeded peers in detailing different reasons to show benefits of one answer opposed to the other, received multiple awards such as team player and top 5 fastest processors.
October 2022-February 2023
Broadpath, Edgewood, MD
Remote Provider Services Representative
• Managed high-volume call center operations, successfully resolving 50-80 daily provider inquiries while maintaining strict compliance standards.
• Educated physicians on program information such as health insurance plans and benefit information, coverage, etc.
• Fostered strong relationships with healthcare providers through clear communication and efficient resolution of coverage inquiries.
• Ensured compliance with Broadpath, client policies and HIPAA regulations. Adhered to company policies and scripts to consistently achieve call-time and quality standards. Platforms used: AWS, AMISYS, Salesforce, Portico Credentialing System, all Microsoft programs (i.e. Outlook, Word, Excel), TruCareCloud, HubSpot, Filenet) February 2022- September 2022
American Specialty Health, Baltimore, MD
Remote Provider Services
Representative
• Responded to direct questions from physicians about rates, policies, referrals, and eligibility (identified physicians by NPI, credentialing ID, first/last name or social security number).
• Reviewed and processed insurance claims submitted by policyholders. • Verified all claim information shared by policyholders and physicians, and possible patients to ensure accuracy in claim processing and payment.
• Handled 50-125 daily inbound telephone calls/emails/live chat questions from physician inquiries and resolving complaints.
• Assisted physicians regarding website registration/navigation and customer related inquiries, responded to inquiries by directing calls to appropriate personnel. • Communicated with major health plans such as Cigna, Molina Healthcare, and Anthem BCBS and coordinated with them to resolve complex physician queries. October 2021- February 2022
Conduent, Baltimore, MD
Remote Data Entry Specialist
• Corrected data entry errors to prevent issues such as duplication or data degradation to prevent issues with customers’ orders with little to no supervision.
• Communicated with supervisors and colleagues to process data quickly and resolve discrepancies.
• Established data entry standards by continually updating filing systems to improve data quality.
• Software/Platforms used: Genesys, AWS, all Microsoft programs. Platforms used: Genesys, AWS, all Microsoft programs. September 2020-October 2021
Abacus Staffing, Baltimore, MD
Temp Agent
Covid Tester (October 2020-October 2021)
• Assigned to different schools to test children and adults (Spit tube and nose swab); tested over 100 people every Wednesday.
• Familiarized HIPAA and the violations of the policy before gathering results or any other personal information from patients (students/faculty). Sent spit samples in sealed bags weekly to get results the following week. Student Record File Clerk (September 2020- October 2020)
• Worked with BCPSS (Baltimore City Public School System) to organize student records for 2020-2021 SY, all grades.
• Organized hundreds of student records by first/last name, age, grade, and school name and packaged into boxes to be sent to different schools.
• Established systematic record management protocols for student files, organizing documentation by multiple criteria for efficient distribution across school districts.
January 2019- July 2019
TravelCenters of America, Baltimore, MD
Truck Service Advisor/Shift Supervisor
• Assisted with processing and payout of work orders and OTC transactions for truck services.
• Learned how to properly write an ETA work order and secure purchase orders to communicate quotes to customers.
• Maintained strong company product and service knowledge to better assist customers with concerns, questions, and general education and managed to maintain inventory sales with advertisements and grouping coupons.
EDUCATION
Baltimore City College High School
Graduated 2017
3220 The Alameda
Baltimore, MD 21218
Cumulative GPA: 3.50
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