Reynalda Juarez
Childress,Texas
Summary
Assisted in processing Medicaid claims for Texas and Oklahoma. Adapted quickly to new systems and procedures. Pursued opportunities for professional development to enhance job efficiency.
Overview
2026
2026
years of professional experience
Work History
Medicaid Pending Specialist
Slp Operations
Bedford, Tx
10.2022 - Current
- Monitor Medicaid residents at risk for disqualification on annual renewal applications.
- Monitor Trust Fund for Medicaid residents to ensure not over the resource limit.
- Assist centers with completing Medicaid renewal applications yearly.
- Monitor the status of Medicaid/SSI applications and provide documented updates on each account.
- Assist with center accounts receivable reviews, and guide complex Medicaid/SSI Pending cases.
- Ensure payers are accurate for all Medicaid/SSI Pending, approved, and denied cases as needed.
- Assist with sending weekly communication tools, and document response, as needed.
- Review Medicaid applications and documents for newly admitted residents, to ensure eligibility.
- Communicate with the BOM, RAM, state Medicaid, and Social Security office to follow up on Medicaid/SSI applicants, as needed.
- Support the BOM in providing consultation, guidance, and oversight of the Medicaid/SSI process.
- Support the RAM by assisting with orientation and training of the BOM on the Medicaid/SSI processes as needed.
- Communicate with residents/responsible parties regarding Medicaid Applications and associated documents.
- Attend training, meetings, and seminars when necessary.
- Other duties as assigned.
Business Office Manager
Slp Operations
Childress, TX
2017 - 2022
- Managed daily operations, ensuring efficient workflow and adherence to company policies.
- Developed and implemented budget tracking systems to optimize financial performance.
- Led cross-departmental initiatives to enhance communication and streamline processes.
- Mentored staff on best practices for administrative functions and customer service excellence.
- Updated reports, managed accounts, and generated reports for company database.
- Enhanced customer satisfaction by addressing inquiries promptly and resolving issues professionally.
- Ensured compliance with company policies and industry regulations through regular audits and process updates.
- Conducted performance evaluations for employees, identifying areas for improvement and providing constructive feedback.
- Implemented employee training programs, increasing overall staff competency and reducing skills gaps.
- Increased team productivity with introduction of flexible work schedules, accommodating personal needs while ensuring coverage.
Certified Nursing Assistant
SLP
Childress, TX
2004 - 2022
- Provided compassionate patient care, assisting with daily living activities and personal hygiene.
- Monitored vital signs and reported changes to nursing staff for timely intervention.
- Assisted in maintaining a clean and safe environment, adhering to infection control protocols.
- Documented patient progress accurately, ensuring compliance with healthcare standards and regulations.
Education
High School Diploma - undefined
05.1999
Skills
- Customer relations
- Expert problem solving
- Analytical thinking
- Documentation management
- Quality assurance
Languages
Spanish
Native or Bilingual
Other Activities
- Notary in Texas
- I have managed 10-15 Texas nursing homes from north Texas to South Texas. Averaging 300k-400k in approvals monthly. I have worked remotely and traveled to my assigned buildings.
- Travel is not issue.
Timeline
Medicaid Pending Specialist
Slp Operations
10.2022 - Current
High School Diploma - undefined
Business Office Manager
Slp Operations
2017 - 2022
Certified Nursing Assistant
SLP
2004 - 2022