Human Resource Specialist
Resume:
Evelyn Davis
Human Resource Specialist
**** ******* *******, *********, ** 20770, Greenbelt, US,
20770
********@*****.***
Professional summary
Human Resource Specialist with 12 years of experience in medical billing, HR systems, and performance enhancement. Demonstrates strong decision-making and planning skills, with a proven track record in expense reduction and efficiency maximization. Adept at communication and interpersonal skills, ensuring seamless operations and compliance with state requirements.
Employment history
Fema Payroll Specialist Washington, DC
Jan 2023 - Present
• Manage WebTA accounts, ensuring accurate data entry and timely audits.
• Streamline payroll processes, enhancing efficiency and compliance.
• Develop automated systems to track and report key administrative metrics.
• Validate timecards for deployed employees and Reservists, ensuring correct codes and data.
• Address inquiries on WebTA, accounting codes, and premium pay, providing clear guidance.
• Enhances payroll process efficiency, ensuring timely compliance and audits.
• Develops new automated tracking systems to optimize administrative operations.
• Analyzes and verifies timecard data accuracy, improving report generation.
• Provides expert guidance on WebTA and payroll issues, boosting team productivity.
• Oversees payroll accuracy, ensuring zero discrepancies in employee payments.
• Evaluates payroll protocols to cut processing time by 20%. United Healthcare Care Navigator
Jun 2019 - Jan 2023
Utilizes critical thinking and judgment to manage, collaborate, and inform the case management process.
• A problem solver with the ability to meet demanding deadlines with efficient and effective results.
• Conduct comprehensive evaluation of referred member’s needs/eligibility and recommend a management approach for resolution.
• Provide expert technical guidance/advisory services to customers and their family.
• Service as a Subject Matter Expert involving all matter related to case management.
• Conducts training on new guidance/regulations issued.
• • Develops formal written advisory opinions in response to customer requests.Evaluated member eligibility, enhancing case resolution effectiveness.
• Streamlined case management processes, boosting efficiency.
• Provided guidance to customers, improving their understanding of services.
• Pioneered training sessions on new regulations, elevating team competence.
• Crafted detailed advisory opinions, ensuring regulatory compliance.
• Analyzed client needs to optimize healthcare pathways, improving service delivery. Chase Brexton Healthcare Eligibility Management Specialist Jan 2015 - Jun 2019
Agency expert involving all title 38 and title 5 compensation, labor laws, and pay administration.
• Prepared reconsideration for Medicare, resulting in payment to customer.
• Maintain knowledge of insurance information related to provider credentials.
• Identify patient needs and issues and worked to resolve the problem while advocating for the patient.
• Manage patient information via the Patient Management System and EMR.
• Detects and corrects errors, complete forms, obtains needed information and maintains logs and files.
• Performs retroactive claims audit on Medicare and commercial primary determination.
• Managed outreach activities, special events, programs, and presentations to support member education and health plan awareness within the Medicaid and Medicare community.
• Managed staff of 3, to include attendance, conduct and performance.
• Managed quality assurance activities such as any client feedback regarding problems with access or quality of services and communicating findings to relevant entity.
• Conducts training on new guidance/regulations issued.
• • Develops formal written advisory opinions in response to customer requests.Streamlined patient data management, enhancing system efficiency and accuracy.
• Led a team of 3 to boost Medicare/Medicaid community engagement and satisfaction.
• Conducted thorough audits, ensuring compliance with healthcare regulations.
• Implemented innovative outreach strategies, increasing health plan literacy.
• Trained staff on updated regulations, improving team performance and knowledge.
• Analyzed patient data trends to enhance service delivery accuracy. Children’s Pediatricians and Associates, LLC Senior Patient Service Representative Oct 2012 - Jan 2015
Served as an expert, Human Resources liaison, and change agent responsible for assisting in the development and implementation of high performance and organizational effectiveness strategies for directors, managers, and employees.
• Responsible for greeting patients and visitors.
• Scheduling appointments for 9 physicians and 2 nurse practitioners and 14 residents.
• Gathered demographics and charge data for billing and inputting procedures and diagnostic codes for the productions of insurance forms and statements.
• Maintains patient record filing system.
• Chart checks for all upcoming appointment.
• • Liaison between outside Specialist and Pediatric staff.Enhanced patient experience by ensuring accurate, timely medical record management.
• Streamlined appointment processes, reducing wait times and improving satisfaction.
• Facilitated seamless communication between specialists and staff to optimize care.
• Implemented a digital filing system that expedited patient data retrieval.
• Monitored and analyzed patient flow to enhance operational efficiency.
• Optimized 9 physicians' schedules, boosting clinic efficiency. Education
University of Maryland Global Campus, Adelphi, Maryland Human Resources Jan 2020 - Present
Currently 20 credits away from degree.
Courses
Managing time for Professional Leadership Skills for Non-supervisors May 2024 - May 2024
Managing Multiple Priorities, Projects, and Bosses Jun 2015 - Jun 2015
UMGC Writing Skills
Jun 2000 - Jun 2024
Umgc Project Management
Apr 2016 - Jul 2022
Managing Change
Aug 2016 - Aug 2016
Chase Brexton Gray Matters: Critical Thinking & Decision Making Jun 2015 - Jun 2015
Skills
Medical coding (Skillful) Medical billing (Experienced) Insurance claims processing (Skillful) Insurance regulations HR systems (Experienced) Leadership (Experienced)
Time management (Experienced) Decision-making (Expert) Efficiency maximization (Experienced) Expense reduction (Experienced) Performance enhancement (Experienced) Problem solving (Expert) Research (Experienced) Multi-tasking (Expert)
Planning (Expert) Prioritizing (Experienced)
Interpersonal skills (Expert) Communication skills (Experienced)
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