Bumaa Clark
Denver,CO
Summary
Dedicated professional prepared to bring extensive expertise and results-oriented approach to Specialist role with over 9 years of experience. Known for effectively managing tasks and supporting organizational goals through collaborative efforts and adaptive strategies. Recognized for excellent communication and analytical skills, ensuring seamless operations and consistent outcomes. Skilled specialist with proven track record in delivering impactful results. Adept at team collaboration and flexible in adapting to changing needs. Expertise in Eligibility & Financial Determination, with strong skills in data analysis, regulatory compliance, and problem-solving. Known for reliability and consistently achieving successful outcomes.
Overview
26
26
years of professional experience
Work History
Financial & Eligibility Determination Specialist / Eligibility & Financial Re-Determination Representative
InnovAge/PACE
06.2018 - 10.2024
- Reviewed and managed Medicaid applications and re-determinations, ensuring compliance with state and federal regulations while making informed decisions to maintain uninterrupted coverage for participants.
- Collaborated with Enrollment Representatives and county agencies to gather necessary documentation, troubleshoot complex cases, and resolve eligibility issues efficiently, utilizing strong decision-making skills to address challenges.
- Proactively monitored aging reports, identifying and resolving aged items to prevent lapses in coverage, while simplifying complex LTC/Medicaid policies for participants and caregivers to support informed decision-making.
- Responded promptly to notices from county technicians, applying critical thinking to resolve issues and provide leadership and guidance to the Enrollment Representative team, fostering positive morale and teamwork.
- Maintained detailed records for compliance audits, ensuring all processes met regulatory guidelines and regularly updated internal stakeholders on changes and statuses.
- Championed the adoption of new software tools that streamlined workflows across multiple departments.
Eligibility Specialist
MAXIMUS Inc /MMC Strategic Staffing Services
11.2016 - 06.2018
- Processed applications for medical coverage through the State of Maryland Marketplace, enrolling consumers in Medicaid, Qualified Health Plans (QHP), and the Children's Health Insurance Program (CHIP) while ensuring accurate eligibility determinations.
- Provided education on various health insurance options, including Medicaid, QHPs, and CHIP, helping consumers understand their coverage and benefits.
- Advised consumers on required documentation to verify eligibility, facilitating timely approvals and informed decision-making.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
- Managed approximately 12-15 cases per day and outgoing calls, emails and faxes.
Instructor
Science Matters in America
12.2011 - 08.2016
- Engaged K-6 students in science through interactive experiments and tailored lesson plans that fostered curiosity and participation
- Collaborated with fellow educators to integrate cross-curricular activities, enriching the educational experience
- Promoted a positive learning environment by establishing clear expectations and maintaining consistent classroom management techniques.
- Increased student motivation by developing engaging lesson plans that catered to various learning styles.
- Enhanced classroom collaboration through the implementation of group projects and team-building activities.
Transportation Coordinator
LogistiCare
05.2008 - 12.2008
- Managed and coordinated dispatching of 25-35 transportation services daily for medical clients, verifying insurance coverage and authorizing providers for Medicaid, Medicare, and special-needs populations
- Worked closely with medical providers and transportation vendors to ensure reliable access to critical treatments, including chemotherapy, dialysis, and specialist appointments
- Assisted patients in resolving transportation challenges, troubleshooting scheduling conflicts and last-minute changes to ensure timely access to care
- Maintained detailed records of transportation authorizations and client interactions, ensuring compliance with Medicaid and Medicare guidelines while streamlining service delivery
- Provided compassionate support to patients and their families, helping them navigate the transportation system for medical care efficiently
Tour Guide & Translator
Guulchin LLC
06.1998 - 09.2002
- Led tours in multiple languages, broadening audience reach and inclusivity of tour offerings.
- Ensured timely departures and arrivals by strictly adhering to schedules while remaining flexible enough to accommodate unforeseen circumstances or special requests from guests.
- Collaborated with local businesses to include exclusive stops on tours, enhancing guests' experiences and supporting community.
- Managed scheduling and logistics for multiple tour groups , ensuring smooth operation and timely departures. Guided groups of up to 24 people on scheduled tours.
- Stayed current on area history, culture, events, attractions by attending workshops, lectures, conferences regularly updating tour information accordingly.
Education
Bachelor of Arts - TOUR GUIDE/INTERPRETER/TRANSLATOR
University of Humanities
UB, Mongolia 01.1998
Skills
- Customer relations
- Documentation management
- Excellent verbal and written communication
- Effective program oversight
- Proficient in data management
- Proficient in Excel
- Proficient in Microsoft Word
- Teamwork and collaboration
- Time management abilities
- Root-cause analysis
- Expert problem solving
- Coaching and mentoring
Professional Development
- Certification in Medicaid Compliance, 2018
- Workshop on Effective Communication, 2018
- Course in Data Management and Analysis, 2018
Timeline
Financial & Eligibility Determination Specialist / Eligibility & Financial Re-Determination Representative
InnovAge/PACE
06.2018 - 10.2024
Eligibility Specialist
MAXIMUS Inc /MMC Strategic Staffing Services
11.2016 - 06.2018
Instructor
Science Matters in America
12.2011 - 08.2016
Transportation Coordinator
LogistiCare
05.2008 - 12.2008
Tour Guide & Translator
Guulchin LLC
06.1998 - 09.2002
Bachelor of Arts - TOUR GUIDE/INTERPRETER/TRANSLATOR
University of Humanities
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