Work Preference
Summary
Overview
Work History
Education
Skills
Timeline
StoreManager
Open To Work

Amy Short

Program Coordinator
Lexington,KY

Work Preference

Job Search Status

Open to work
Desired start date: 2 weeks notice

Desired Job Title

Administrative Specialist SeniorMedicaid/Medicare Services Specialist IMedicaid/Medicare Services Specialist IIProgram Coordinator

Work Type

Full Time

Location Preference

HybridOn-SiteRemote
Location: Lexington, KY, USFrankfort, KY
Open to relocation: No

Salary Range

$45000/yr - $80000/yr

Important To Me

Company CultureHealthcare benefitsPersonal development programsWork-life balance

Summary

Program coordinator specializing in compliance analysis and data reconciliation. Demonstrated success in training staff and improving operational efficiency. Strong attention to detail ensures accurate project execution and adherence to regulations.

Overview

11
11
years of professional experience

Work History

Program Coordinator

Department for Medicaid Services
Frankfort
09.2020 - Current
  • Responded to member and provider inquiries regarding DMS issues and appeal information, ensuring timely resolution and support
  • Research and resolve provider requests on EITPR cases
  • Researched and resolved provider email requests for EITPR cases, facilitating effective communication and issue resolution
  • Review and process MedImpact EITPR cases
  • Training staff in the process of email inbox and provider emails
  • Train staff, serve as back-up and support for administrative hearings
  • Complete IPRO monthly billing reconciliation
  • Developed and interpreted policies and procedures to ensure compliance and streamline program operations

Health Policy Specialist I

Department of Insurance
Frankfort
01.2019 - 04.2020
  • Researched and analyzed health care information to support compliance and informed decision-making on Life & Health/Senior insurance planning and policies.
  • Researched, reviewed, and synthesized healthcare information for compliance and accuracy
  • Reviewed and organized Life and Health/Senior Products documents to ensure proper branch filing and regulatory compliance.
  • Evaluated product forms to ensure adherence to regulatory standards.
  • Provided technical assistance to division, branch, insurers, public and applicants regarding policy issues/assist to resolve consumer issues

Program Coordinator

Department for Medicaid Services
Frankfort
10.2014 - 12.2018
  • Coordinated the state fair and administrative hearings program.
  • Processed administrative appeals requests for members, providers, and third-party external reviews, ensuring compliance and timely resolution.
  • Conducted in-depth analysis of appeal and hearing data to identify trends and support decision-making.
  • Testified on behalf of DMS in fraud cases.
  • Prepare Medicaid Assistance Utilization reports for fraud and abuse cases for OIG and the U.S. Attorney's Office
  • Monitored contract with Administrative Hearings Branch
  • Monitored administrative hearings email, responding promptly to inquiries to facilitate communication among parties.
  • Received hearing correspondence from all involved parties within the managed care organization.
  • Interpret laws, regulations, contracts, and policies/procedures
  • Interpret laws, regulations, contracts, and policies/procedures
  • Entered information in OIG/third-party external appeals/provider/member database

Education

Bachelor of Arts - Political Science

University of Kentucky
Lexington, KY
12-2012

Bachelor of Arts - Geography

University of Kentucky
Lexington, KY
12-2012

Skills

  • Program coordination and multitasking
  • Compliance analysis and process improvement
  • Data reconciliation and management
  • Case management and customer relationship management
  • Administrative support and staff training
  • Standard operating procedures
  • Critical thinking and problem solving
  • Attention to detail and self-motivation
  • Member engagement

Timeline

Program Coordinator

Department for Medicaid Services
09.2020 - Current

Health Policy Specialist I

Department of Insurance
01.2019 - 04.2020

Program Coordinator

Department for Medicaid Services
10.2014 - 12.2018

Bachelor of Arts - Political Science

University of Kentucky

Bachelor of Arts - Geography

University of Kentucky

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Amy ShortProgram Coordinator