Angela Tamoosh
Plymouth,MA
Summary
Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs. Forward-thinking Regional Manager with deep understanding of market conditions and regional preferences. Decisive and hardworking leader skilled in making proactive, insightful updates to policies and procedures. Prepared to leverage 9 years of progressive Dental experience to positively impact business operations. Dedicated to forming trusting relationships and advocating for best interest of clients within the lower income population. Expertise in Medicaid. Respectful and compassionate professional offering 9-year background serving community by providing guidance for clients in need.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Eligibility Specialist
MassHealth
03.2023 - Current
- Resolved discrepancies with client applications to verify eligibility.
- Communicated with people from various cultures and backgrounds on application process.
- Processed and certified documents for accuracy and compliance with government regulations.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Interviewed applicants and explained scope of different available benefits.
- Assisted clients with accurate eligibility form, application and document completion.
- Assist individuals and families, individuals with disabilities, and others to determine initial and continued eligibility for MassHealth benefits.
- Process applications and administer case management via phone or in-person.
- Assist members to navigate and complete online applications.
- Evaluate and review submitted documents to ensure accuracy and completeness of information.
- Validate customer demographic, financial, and background data through contacting applicants and collateral sources.
- Provide requested services and appropriate referrals for customers to external programs for which they may qualify.
- Validate customer demographic, financial, and background data.
- Represent the agency at hearings and explain eligibility determinations.
- Reconcile MassHealth case information with information from other agencies and sources.
- Respond to customer inquiries and provide information regarding eligibility requirements.
- Provide quality customer service by responding to inquiries in a professional, efficient, and courteous manner.
- Devised and implemented strategies to streamline eligibility verification processes.
- Developed extensive fact-checking and research skills by continuously reviewing different programs and options.
Regional Manager
Dr. Dental
11.2016 - 10.2022
- Oversee office in the northeast territory providing direction, leadership, coaching and support
- Ensuring offices achieve financial objectives, operating efficiency and excellence in patient care
- Achieved top results by building high-performing cohesive teams with a focus on operation effectiveness and maximizing growth while utilizing my teams strengths and opportunities to build a strong talent bench
- Provide continuous direction and support to direct reports while coaching and training on operational priorities like productivity, schedule management, expense management, billing, authorizations, approvals, claims management and increasing new patient flow
- Analyze business and financial data on a daily basis to recognize and build on strengths, provide daily feedback to Office Managers to improve weak areas of performance and identify anomalies occurring in the region
- Identify, develop and recruit high caliber talent and continuously build a healthy pipeline of future leaders.
- Worked diligently to resolve unique and recurring complaints, promoting loyalty, and enhancing operations.
- Managed P&L to decrease discrepancies and retain timely and under-budget project completion.
- Built and deepened partnerships with industry leaders to strengthen collaborative efforts and promote mutual profitability.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Assisted clients with completion of applications and paperwork.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals.
PSR
Aspen Dental
06.2014 - 11.2016
- Greet and Check-in patients in a friendly manner
- Collect co-payments and verify insurance coverage
- Schedule and confirm patient appointments
- Responding and researching patient billing and financial inquiries
- Collect and post payments, balancing accounts as needed
- Consistently ensuring a full schedule while maximizing production.
Education
High School Diploma -
Plymouth South High School
Plymouth, MA06.2006
Skills
- Communication
- Dentrix
- Care Credit
- Leadership
- Time Management
- Project Management
- Customer Service
- Teamwork
- People Skills
- Applicant Engagement
- Resource Information
- Documentation and Paperwork
- Effective Communication Skills
- Proficiency in Medicaid
- Proficiency in Excel
Certification
- CPR certification
- HIPPA
- OSHA
Accomplishments
- Achievements/Tasks
Languages
English
English
Personal Information
Title: Management
Hobbies and Interests
- Team building activities
- Sports
- Music
- Art
- Family
Fluent in English and Greek
English-Advanced proficiency level
Greek-Advanced proficiency level
Timeline
Eligibility Specialist
MassHealth
03.2023 - Current
Regional Manager
Dr. Dental
11.2016 - 10.2022
PSR
Aspen Dental
06.2014 - 11.2016
High School Diploma -
Plymouth South High School
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