Briana Brown
Atlanta,GA
Summary
Medicaid and Quality Assurance professional with expertise in government program support, case processing, eligibility operations, quality review, customer service, documentation, and administrative function. Proven ability to maintain accuracy under high-volume workloads while effectively collaborating with cross-functional teams to enhance service delivery and compliance.
Overview
9
9
years of post-secondary education
8
8
years of professional experience
Work History
Provider Enrollment Representative
Public Consulting Group
02.2026 - Current
- Work on the Oversight Team with Ohio Department of Medicaid | Remote
- Process provider enrollment applications and supporting documents while ensuring information is complete, accurate, and properly recorded.
- Review, update, and verify provider application documents and electronic records in accordance with established policies and procedures.
- Respond to inbound provider and applicant inquiries regarding enrollment, compliance reviews, and site visit scheduling, providing clear and professional assistance.
- Collaborate with internal teams to support efficient provider enrollment processing and timely resolution of provider questions and requests.
- Schedule appointments for provider reviews, assessments, site visits, and related enrollment activities.
- Maintain accurate electronic provider files and records while meeting established productivity, quality, and timeliness standards.
- Create accurate call logs, document provider interactions, monitor voicemail messages, and return calls in a timely manner.
- Use Microsoft Word, Excel, Outlook, Sharepoint, internet-based systems, and electronic case management tools to support enrollment operations and provider relations.
- Exercise independent judgment within established procedures, identify missing or inconsistent information, and escalate issues when appropriate.
- Distribute electronic fax documents to appropriate staff and assist with document uploads and other administrative workflow activities.
Case Reviewer
Public Consulting Group
11.2025 - 02.2026
- Massachusetts Department of Transitional Assistance | Remote- Contract
- Conduct detailed quality reviews of cases using standardized review tools and established procedures to ensure accuracy, consistency, and integrity of findings.
- Navigate multiple electronic platforms and case management systems to research applications, supporting documentation, and case history.
- Identify processing errors, determine root causes, document findings, and communicate issues clearly to support corrective action.
- Manage high-volume case reviews while maintaining accuracy, productivity, and established deadlines.
- Research and evaluate case information to determine appropriate outcomes in accordance with program requirements and established procedures.
- Maintain accurate electronic case documentation and ensure information is complete and properly recorded.
- Contribute to continuous improvement efforts by identifying recurring issues and opportunities to strengthen processes.
- Prepare spreadsheets and correspondence to support workflow tracking, communication, and operational coordination.
- Demonstrate strong attention to detail while working with confidential government program
Economic Support Specialist
Georgia Department of Community Health
12.2021 - 12.2023
- Remote | Contract
- Processed and evaluated applications and renewals for Georgia Department of Community Health programs, including ABD Medicaid resources, while following established eligibility and program procedures.
- Interviewed applicants and recipients, collected and evaluated medical and financial information, and reviewed documentation to determine program eligibility.
- Monitored application status, deadlines, and required information to support timely processing and resolution.
- Managed, researched, and reviewed cases using electronic systems while maintaining accurate and complete case documentation.
- Responded to applicant and family questions, concerns, and complaints by providing clear information and appropriate resolutions.
- Identified case errors and discrepancies, researched underlying issues, and applied established procedures to determine appropriate outcomes.
- Coordinated scheduling and communications with applicants and families to facilitate timely application and renewal processing.
- Maintained confidentiality while handling sensitive medical, financial, and government program information.
- Managed competing priorities and high-volume workloads while meeting established deadlines and quality expectations.
Assistant Bookkeeper
Radiant Freight
Atlanta, GA
02.2019 - 05.2022
- Hybrid
- Performed detailed data entry, account reconciliation, payroll assistance, journal entries, invoicing, and financial record maintenance.
- Monitored schedules and financial processes for accuracy, completeness, and timely completion.
- Responded to client questions and concerns and provided professional customer service and issue resolution.
- Assisted with daily, weekly, and month-end processes while maintaining accurate documentation.
- Prepared financial statements and reports and supported management with variance analysis.
- Documented best practices and assisted with implementing cost-saving and process-improvement strategies.
- Managed multiple priorities while maintaining attention to detail and established deadlines.
Education
Sociology -
Georgia State University
01.2016 - 12.2019
United States Army -
United States Armed Forces
01.2011 - 11.2015
Skills
- Medicaid Operations and Government Programs
- Provider/Case File Management
- Application and Document Processing
- Quality Assurance and Compliance
- Case Review and Error Identification
- Process and Procedure Adherence
- Electronic Records Management
- Data Entry and Documentation
- Team Collaboration and Leadership
- Customer Service and Issue Resolution
- Written and Verbal Communication
- STEM Knowledge including Microsoft 365 and TEAMS
Timeline
Provider Enrollment Representative
Public Consulting Group
02.2026 - Current
Case Reviewer
Public Consulting Group
11.2025 - 02.2026
Economic Support Specialist
Georgia Department of Community Health
12.2021 - 12.2023
Assistant Bookkeeper
Radiant Freight
02.2019 - 05.2022
Sociology -
Georgia State University
01.2016 - 12.2019
United States Army -
United States Armed Forces
01.2011 - 11.2015