Caelyn Swafford
Catos Clothing
Van Buren,AR
9
years of professional experience
Adept Medicaid Billing Specialist with a proven track record at Methodist Village Senior Living, enhancing billing operations and reducing claim denials through meticulous audits and continuous improvement efforts. Skilled in ICD-10 coding and critical thinking, adept at navigating complex billing issues and training colleagues, significantly improving Medicaid reimbursement performance.
Work History
Manager's Assistant
1 Month- Coordinated daily store operations, supporting manager decisions and team productivity.
- Tracked inventory levels, replenished merchandise, and resolved stock discrepancies.
- Scheduled associates and adjusted coverage for peak sales and staffing needs.
- Assisted with visual merchandising standards to maintain organized, customer-ready sales floor.
- Monitored register accuracy, cash handling, and end-of-day reconciliation procedures.
- Trained new associates on store policies, service expectations, and operational routines.
Activities Director
1 Year 3 Months- Directed resident activity programs aligned with care plans, interests, and therapeutic needs.
- Coordinated daily calendars, special events, and holiday celebrations for diverse resident populations.
- Supervised activity staff, volunteers, and student helpers to ensure consistent program delivery.
- Documented resident participation, preferences, and progress in compliance with facility requirements.
- Collaborated with nursing, social services, and therapy teams to support individualized engagement goals.
- Developed dementia-friendly activities promoting socialization, cognition, and emotional well-being.
- Scheduled community outings, entertainment, and family events to enrich resident experience.
Receptionist
9 Months- Managed patient check-in, appointment scheduling, and front desk flow for seamless clinic operations.
- Coordinated insurance verification, referrals, and eligibility questions with accuracy and professionalism.
- Answered multi-line calls, routed inquiries, and maintained prompt communication with patients and staff.
- Updated electronic patient records and protected confidential information according to privacy standards.
Medicaid Billing Specialist
6 Years 6 Months- Regularly audited client records to ensure proper coding and adherence to state guidelines.
- Participated in continuous improvement initiatives aimed at enhancing overall billing operations within the department.
- Reduced claim denials by proactively addressing potential issues prior to submission.
- Supported management with ad hoc reporting requests related specifically to Medicaid reimbursement performance.
- Assisted in training new team members, sharing expertise on efficient Medicaid billing processes.
- Served as a reliable source of information for colleagues regarding changes to Medicaid policies or procedures, promoting a well-informed team environment.
- Collaborated with healthcare providers to obtain necessary documentation for accurate billing and reimbursement.
- Enhanced billing accuracy by diligently reviewing Medicaid claims and identifying discrepancies.
- Conducted comprehensive research to resolve complex billing issues, securing proper payment for services rendered.
- Managed a high volume of cases while maintaining strict attention to detail and adhering to tight deadlines.
- Prevented revenue loss by quickly identifying trends or patterns in denied claims, taking corrective action accordingly.
Education
Associate of Science - General Studies
Skills
ICD-10 Coding Familiarity
CPT coding knowledge
HIPAA Compliance Understanding
Critical thinking abilities
Adaptable to change
Continuous Improvement Mindset
Strong analytical skills
Appeals process knowledge
Payment Posting Expertise
Records Research
References
Karen Jones - Professional - 479-414-4047
Kristi Graham - Professional - 479-459-0418
Debbie Dunn - Personal - 479-806-6940
Timeline
Manager's Assistant
Catos Clothing
09.2026 - CurrentRead More
Activities Director
The Oaks Healthcare Center
06.2025 - 09.2026Read More
Receptionist
Hamby and Hamby Family Wellness Clinic
08.2024 - 05.2025Read More
Medicaid Billing Specialist
Methodist Village Senior Living
02.2018 - 08.2024Read More
Arkansas Tech University
Associate of Science from General Studies
Read More