Demonstrated expertise in delivering comprehensive claims, project, customer, and operational support to clients at the Federal, State, and Private sector levels.
KEY SKILLS
• Claims Processing
• Customer & Client Communication
• Regulatory Support
• Entry-level proficiency in medical terminology
EXPERIENCE
Benefits Program Specialist I
Mississippi Division of Medicaid, Pascagoula, MS 07/2022 to Present
• Conducting thorough verification checks to ensure the accuracy of financial and other information listed on applicants' applications and redetermination forms, which is critical to their approval.
• Managing a high-volume caseload of 75 to 200 cases monthly, ensuring that all cases are reviewed and processed efficiently and effectively.
• Interviewing applicants to gain a better understanding of their needs and determine eligibility, making recommendations for Medicaid coverage accordingly.
• Providing referrals to external resources based on individual needs, helping applicants’ access additional support and services as needed.
• Developing spreadsheets and calendars to maintain accurate and organized records of all caseloads, schedules, and other critical data, ensuring that all information is up to date and easily accessible.
Regulatory Officer
Durbin, Ocean Springs, MS 06/2015 – 12/2019
• Ensured compliance with FDA and international Ministries of Health regulations by coordinating with Quality Control and other departments as needed.
• Maintained strict compliance to U.S. government agency rules and regulations for domestic exporting policies and regulations and country-specific importing policies to avoid regulatory penalties.
• Monitored legal contracts for expiry and involved parties and updated on average.
• Assisted with department and onsite warehouse audits on a daily, weekly, and monthly basis.
• Maintained vendor and customer files by reviewing them monthly and yearly.
• Processed customer inquiries for technical issues, product recalls, and shelf life verification.
• Conducted background checks and documentation investigations for new international customers and vendors to
ensure authenticity.
• Processed and maintained database of Certificate of Analysis documentation.
• Responsible for updating company Standard Operating Procedures and providing training to associates and new
staff.
• Processed new applications and renewals of State and Federal Wholesale and Controlled Drug Licensing.
Claims Assistant
Browngreer PLC, Biloxi, MS 05/2012 – 06/2015
• Evaluated and assigned values to claims by conducting detailed reviews of complex documents while ensuring the integrity of claims data, using administrative skills such as data entry, document categorization, and related tasks.
• Recognized for providing excellent customer service by consulting with over 500 claimants to determine eligibility, the appropriate type of claim, and required documentation to streamline processing, utilizing strong communication and problem-solving skills.
• Managed day-to-day office operations, including FedEx shipping arrangements, office inventory and supply management, utilizing administrative and organizational skills to ensure smooth office functioning.
• Scheduled and coordinated claimant interviews and tracked all claimants and claimant account activity as assigned, averaging 30 claims per day, using administrative and organizational skills to maintain accurate records and meet deadlines.
• Created and maintained reports and lists using Excel spreadsheets, utilizing technical and administrative skills to organize and present information effectively.
Staging Area Manager
Waste Management, Gulfport, MS 05/2010 – 02/2011
• Supervised 10-20 roll-off drivers and up to 50 on call emergency project drivers, ensuring the efficient and safe operation of all vehicles.
• Led mandatory daily pre-shift safety briefings and vehicle inspections, ensuring that all drivers adhered to safety guidelines and regulations.
• Recorded driver attendance and disciplinary actions in accordance with Waste Management policies, ensuring consistency and fairness in all disciplinary actions.
• Recognized and resolved safety, service, and operational issues, ensuring that all issues were addressed in a timely and efficient manner.
• Compiled daily production reports and conducted staging area inventory control, ensuring that all inventory w...
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