CIERA ROUNDS

• Conduct home visits and interviews to assess the needs of individuals.

• Determine eligibility for Community Care for the Aged and Disabled (CCAD) services.

• Document information and develop service plans based on individual needs.

• Verify data and explain program benefits and requirements to individuals.

• Authorize and monitor CCAD services to ensure they meet individual needs.

• Maintain case records and enter information into automated systems.

• Establish and maintain effective relationships with individuals receiving services and other stakeholders.

• Accurately determining Medicaid eligibility
• Interviewing clients in person or via phone call
• Documenting and verifying case data
• Explaining program benefits and requirements
• Apply complex policies and procedures

• Handled initial investigation and processing of insurance claims, collecting facts and statements from involved parties.
• Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
• Investigated claim details, reviewed policy terms, and ensured accurate and timely claim payments.
• Adhered to company policies and procedures, as well as relevant regulations and guidelines.

• Responsible for front end operations and directed associates
• Prepared and audited register tills
• Customer care problem solving
• Employee of the month multiple times

• Hired and trained members
• Conducted performance reviews
• Supervised team leads and team members
• Oversaw operations