Cassandra McCray
Clinton,Mississippi
Summary
Earnest individual with experience in human services field providing support and guidance to individuals in need. Strong understanding of effectively working with people from diverse backgrounds. Passionate about helping others access needed services. Devoted professional proactively and quickly identifies best course of action for given scenarios. Confident handling tasks independently and in teams with highly organized approach to work. Strong advocate for those in need and committed to providing best possible service.
Overview
35
35
years of professional experience
Work History
Program Specialist / Medicaid Auditor V
Mississippi Division Of Medicaid
10.2002 - Current
- Accurately update files so Medicaid remains the payer of last resort.
- Identify and investigate third party leads in order to verify the existence or non existence of health insurance coverage.
- Correspond with insurance companies and providers.
- Troubleshoot/Assist with pharmacists in situations in which the beneficiary needs his/ her life saving prescriptions immediately.
- Verify the validity of work files received from sources such as the WEB PORTAL, MEDS, METTS, DEERS, and SSA
- Monitor the work done by TPL Contractors, Health Management Services (HMS)
- Correspond with insurance companies and providers.
- Handle calls from beneficiaries, policyholders and other health providers.
- Guarantee the integrity of the TPL files in claims payment system by maintaining the accuracy of beneficiary files.
- Investigate claims rejected for third party codes.
- Review Explanation of benefits (EOB's)
- Provide excellent customer service
- maintain a good rapport with beneficiaries, insurance companies and coworkers
- Created and delivered program training and education to keep participants knowledgeable about program and provide necessary skills to participate productively.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to learn quickly and adapt to new situations.
- Worked well in a team setting, providing support and guidance.
- Worked effectively in fast-paced environments.
- Managed time efficiently in order to complete all tasks within deadlines.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Excellent communication skills, both verbal and written.
- Proved successful working within tight deadlines and a fast-paced environment.
- Used data entry skills to accurately document and input statements.
- Responded to customer concerns and questions on daily basis.
- Audited and corrected billing and posting documents for accuracy.
- Collaborated with customers to resolve disputes.
- Verified accuracy of accounts payable payments, resulting in [Number]% reduction in payment errors and check reissues.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
- Assessed community needs and identified resources for social and community service programs.
- Collaborated with community members to develop and implement service initiatives.
- Implemented strategies to increase public awareness of social and community service programs.
- Analyzed trends and data to inform decision-making and program development.
- Coordinated individual referrals to obtain community services, advocate for client needs and resolve roadblocks.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Passionate about learning and committed to continual improvement.
- Investigated issues and provided knowledgeable responses to resolve customer concerns.
- Followed detailed directions from management to complete daily paperwork and computer data entry.
Medical Records Clerk
Mississippi State Department Of Health
06.2000 - 07.2002
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Scanned medical records in digital format for easy retrieval and accessibility.
- Assisted in preparation of medical records to release to other medical facilities requesting for patient history and information.
- Maintained patient records in compliance with security regulations.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Responded to patient inquiries to provide information and details of medical records.
- Reviewed charts and flagged incomplete or inaccurate information.
- Analyzed complex medical records to identify discrepancies in accuracy and completeness.
- Input data into computer programs and filing systems.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Maintained accuracy, completeness, and security for medical records and health information.
- Followed exact procedures for handling transfers and other releases of medical records.
- Tracked and monitored requests for medical records release.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Generated and maintained statistical data related to medical records.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Assisted in training new staff on medical record processing and filing procedures.
- Researched and resolved medical record discrepancies.
- Transcribed and entered patient medical information into electronic medical records systems.
Purchasing Agent
VA Medical Center
07.1988 - 07.1990
- Maintained complete documentation and records of all purchasing activities.
- Tracked inventory shipments and prepared spreadsheets detailing item information.
- Communicated with vendors regarding inventory needs and negotiated prices to maintain profit margins.
- Determined lowest possible cost, factoring in quality, and reliability and negotiated favorable contracts.
- Computed and created purchase orders in [System] to monitor stock levels, verify purchase requisitions, and expedite customer orders.
- Computed and created purchase orders to monitor stock levels, verify purchase requisitions and expedite customer orders.
- Solved diverse supply chain problems involving numerous sources, logistics, and scheduling factors.
- Maintained consistent email communication with stores and suppliers to confirm and track orders and verify price revisions on purchase orders.
- Reviewed proposals, qualified vendors, and recommended optimal suppliers.
- Maintained effective and lasting vendor relationships through dynamic communication, collaboration, and intelligent questioning skills.
- Maintained documentation for all purchases.
- Worked with departments to find new and better items to fulfill diverse needs.
- Performed monthly reconciliation of open purchasing orders.
Education
No Degree -
Hinds Community College
Raymond, MSHigh School Diploma -
Provine High School
Jackson, MS06.1980
Skills
- Systems Evaluation
- Client Screening
- Investigates
- Coordination
- Electronic Medical Record (EMR) Software
- Quality Control Analysis
- Microsoft PowerPoint
- Critical Thinking
- Data Entry Software
- Operations Analysis
- Coordinate Service Referrals
- Health Care System
- Information Updates
- Negotiation
- Time Management
- Prepare Reports
- Medical Records Review
- Speaking
- Staff Meetings
- Microsoft Word
- Reading Comprehension
- Quality Improvement
- Data Analysis
- Data Communications
- Maintenance Requirements
- Troubleshooting
- Writing
- Clerical Support
- Agency Liaison
- Customer Service
- Judgment and Decision-Making
- Fine Motor Skills
- Compile Data
- Vision and Dental Insurance
- Customer Satisfaction
- Employee Relations
- Customer Needs Assessments
- Workflow Processes
- Compassionate Care
- De-Escalation Tactics
- Active Listening
Timeline
Program Specialist / Medicaid Auditor V
Mississippi Division Of Medicaid
10.2002 - Current
Medical Records Clerk
Mississippi State Department Of Health
06.2000 - 07.2002
Purchasing Agent
VA Medical Center
07.1988 - 07.1990
No Degree -
Hinds Community College
High School Diploma -
Provine High School
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