ALTON CROWTHER
Rolesville
Summary
Result-oriented case manager with over 10 years of experience leading and managing cross-functional teams to drive process improvements, ensure regulatory compliance, and optimize financial performance. Proven track record of implementing cost-saving initiatives while maintaining high standards. Strong sense of responsibility, accountability, and self-motivation. Excellent written, oral, and interpersonal communication skills, with solid analytical, problem-solving, and leadership skills. Effective time and project management, with superb communication and interpersonal abilities. Goal-oriented Income Maintenance Caseworker with many years of experience. Advanced clerical knowledge with exceptional skills in data archiving and record filing. Excellent interviewing talents to gather, assemble, analyze, evaluate, and calculate client information to determine benefit eligibility.
Overview
12
12
years of professional experience
Work History
Income Maintenance Caseworker
Commonwealth of Pennsylvania
Philadelphia
10.2018 - Current
- Identified cases needing a support order by reviewing case documentation, completing legal forms, gathering income information, and performing support calculation.
- Utilized claims management program to analyze and determine clients' eligibility for financial assistance, other income maintenance program services such as Medicaid, SNAP, LIHEAP, Nursing Home Care, and Waivers as well as any related programs administered by the State.
- Provide ongoing guidance and feedback to community agencies and facilities such as long-term care facilities, Labor Department, and Social Security regarding denial reasons, appeals, outcomes, needed training and implementation of action plans for prevention of disputed claims.
- Developed strategies and mechanisms to ensure timely follow-up of claims denial.
- Review and update denial data to enable accurate compiling of statistics, coordinate meetings, develop office procedures, establish and maintain filing system, maintain logs, proofread documents, and research information based on compiled denial data.
- Create, review and maintain pre-certification, re-certification and concurrent review processes are performed and complete.
- Developed and implemented communication mechanisms that promote accurate and timely reimbursement of cases.
- Assess clients' social service and employment needs and provide clients or their families with information on community resources for social and employment services, assist clients in preparing for and locating employment.
- Created streamlined and effective processes that revitalized departmental productivity and work flows.
- Developed interdepartmental policies and procedures. Created training formats and user manuals for transitions.
Mental Health Technician
Quality Care Options
Willow Grove
07.2018 - Current
- Observe patients: Listen to concerns, observe behavior, and record condition.
- Report changes: Report changes in patient health or behavior to medical staff.
- Lead activities: Lead patients in therapeutic and recreational activities.
- Collaborate with the treatment team: Identify potential patient care problems and ensure the treatment plan is followed.
- Support healthcare professionals: Help nurses, therapists, psychologists, or psychiatrists when conducting examinations or leading therapy sessions.
- Ensure patient comfort: Provide transportation to patients as needed.
- Communicate: Communicate about family members' status and progress as allowed by privacy laws.
- Provide assistance with ADLS.
Program Specialist
Providence Corporation
Philadelphia
07.2017 - 07.2018
- Coordinated waiver approval office with the County assistance office, social security office and other agencies as required by 6400 regulations with 80% success rate.
- Conducted intake assessment for potential patients, while serving as a liaison between Providence and state agencies.
- Conducted interviews, hiring and training of direct support professional and house managers while maintaining a low staff turnover.
- Success completed Office of Developmental Programs (ODP) observer’s monitory with 90% success rate.
- Ensured services provided by Providence Corporation matches individual needs as stipulated in their plan.
Operations Manager
NHS Human Services
Philadelphia
01.2014 - 07.2017
- Developed and implemented a comprehensive compliance program, ensuring adherence to HIPAA, OSHA, and state regulations. Program resulted in zero compliance violations and a 50% reduction in risk exposure.
- Managed annual operating budget, implementing cost-saving measures that resulted in a 15% reduction in expenses without compromising quality of care.
- Developed and implemented a new revenue cycle management process, increasing collections by 20% and reducing days in accounts receivable by 30%.
- Led a cross-functional team of 20+ employees, implementing a new quality control program that reduced errors by 30% and increased productivity by 15%.
- Developed and implemented a comprehensive training program for new hires, resulting in a 50% reduction in onboarding time and a 25% improvement in employee retention.
- Accountable for accurate completion of program activities and participated in Individual Support Plan, Q.E.S.T, S.I.S, Monitoring meetings and Psychiatrist Evaluations.
- Managed three (3) homes with a total number of 9 clients that passed two state inspections with 100% success rate in two.
- Conducted scheduler job functions including managing call-offs, ensuring proper staffing ratio and backs up payroll entry into Kronos / ADP also working with HR department to deliver employee discipline and discharge.
- Successfully managed 9 client accounts, monitoring purchases and bills payments and conduct monthly account reconciliation with the financial managers.
Education
Masters - Health Administration and Health Education
Saint Joseph’s University
Philadelphia09.2026
Security+ - Cyber Security
CompTIA Certifications
03-2023
Bachelor of Science - Political Science and Sociology
Fourah Bay College
Sierra Leone, West Africa05.2008
Skills
- Regulatory Compliance
- Quality Assurance
- Patient Care Management
- Staff Training & Development
- Medical Terminology
- Health Information Systems
- Microsoft Office Suite
- Healthcare Management Systems (HMS)
- Electronic Medical Records (EMR)
- Resource Allocation Systems
- Operations and Revenue Cycle Platforms
- 3M Coding and Reimbursement Systems
- Microsoft Applications (Word, Excel, PowerPoint, Outlook)
- Strategic Planning and Partnership
- Scrum Methodologies
- Budgeting & Resource Allocation
- Risk & Change Management
- Benefits Realizations
- Reporting and Analysis
- Account and Case Management
- CPR
- First Aid
Awards Technical Skills
Trained in administering CPR and First Aid
Highlights
Regulatory Compliance, Quality Assurance, Patient Care Management, Staff Training & Development, Medical Terminology, Health Information Systems, Microsoft Office Suite, Healthcare Management Systems (HMS), Electronic Medical Records (EMR), Resource Allocation Systems, Operations and Revenue Cycle Platforms, 3M Coding and Reimbursement Systems, Microsoft Applications (Word, Excel, PowerPoint, Outlook), Strategic Planning and Partnership, Scrum Methodologies, Budgeting & Resource Allocation, Strategic Planning, Risk & Change Management, Benefits Realizations, Reporting and Analysis, Account and Case Management
Timeline
Income Maintenance Caseworker
Commonwealth of Pennsylvania
10.2018 - Current
Mental Health Technician
Quality Care Options
07.2018 - Current
Program Specialist
Providence Corporation
07.2017 - 07.2018
Operations Manager
NHS Human Services
01.2014 - 07.2017
Masters - Health Administration and Health Education
Saint Joseph’s University
Security+ - Cyber Security
CompTIA Certifications
Bachelor of Science - Political Science and Sociology
Fourah Bay College
Similar Profiles
ERIN PETROVICHERIN PETROVICH
Vocational Rehabilitation Counselor at Commonwealth of PennsylvaniaVocational Rehabilitation Counselor at Commonwealth of Pennsylvania
Swetha KanakavalliSwetha Kanakavalli
.NET Developer at Commonwealth of Pennsylvania.NET Developer at Commonwealth of Pennsylvania
Seth NorcuttSeth Norcutt
Sales Associate at Commonwealth of PennsylvaniaSales Associate at Commonwealth of Pennsylvania
Norman BenzeleskiNorman Benzeleski
State Labor Mediator at Commonwealth of PennsylvaniaState Labor Mediator at Commonwealth of Pennsylvania
Lakisha HooksLakisha Hooks
Community Outreach Specialist at Speech InspirationsCommunity Outreach Specialist at Speech Inspirations