Summary
Overview
Work History
Education
Skills
Timeline
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Connie Spears

Christiansburg,VA

Summary

Professional with strong background in Medicaid eligibility determination and case management. Proven ability to navigate complex regulations and ensure compliance. Strong focus on team collaboration and achieving results. Known for reliability and adaptability in dynamic environments. Expertise in data analysis, client communication, and process improvement.

Overview

8
8
years of professional experience

Work History

Medicaid Eligibility Specialist

LewisGale Hospital Montgomery
02.2024 - Current
  • Maintained up-to-date knowledge of relevant laws, regulations, and policy changes affecting Medicaid eligibility determinations.
  • Improved customer service experience for applicants, providing clear explanations of eligibility requirements and addressing concerns promptly.
  • Enhanced Medicaid eligibility determinations by thoroughly analyzing applicants'' financial and personal information.
  • Resolved eligibility discrepancies by carefully reviewing regulations and collaborating with relevant parties to reach accurate determinations.
  • Collaborated with other specialists to ensure consistent interpretation of Medicaid regulations and policies.
  • Managed high caseloads efficiently, prioritizing tasks effectively and utilizing time-management skills to meet deadlines consistently.
  • Streamlined application processing for increased efficiency by implementing a well-organized case management system.
  • Utilized advanced computer systems to track applicant data, generating accurate reports for internal review as needed.
  • Coordinated closely with other social service agencies, fostering collaboration to ensure comprehensive support for clients.
  • Reduced errors in eligibility decisions with meticulous attention to detail and thorough documentation of applicant information.
  • Achieved timely resolution of cases, conducting comprehensive reviews and maintaining close communication with applicants.
  • Developed strong relationships with healthcare providers, coordinating services effectively to best serve eligible clients.

Financial Counselor

Lewis Gale Hospital Pulaski
06.2022 - 02.2024
  • Registering ER and Outpatient procedure
  • Insurance verification
  • Customer service
  • Collections
  • Running medical necessity
  • Authorization verification
  • Worked with clients to develop personal recommendations for improvement of financial circumstances, reducing debt and increasing income.
  • Cultivated a positive, non-judgmental environment for clients to openly discuss their financial challenges and concerns.
  • Conducted interviews with patients and family members and answered questions regarding insurance benefits.

Registrar II

Lewis Gale Hospital Pulaski
12.2016 - 06.2022
  • Registering ER and Outpatient procedure
  • Insurance verification
  • Customer service
  • Collections
  • Running medical necessity
  • Authorization verification

Education

Diploma - Legal Secretary

Gadsden Business College
Gadsden, Alabama
01.1991

Skills

  • Lotus, Excel, Word, UNIX, Medi-Tech, ACT, Benchmark, Digi Chart

  • Skilled in using web browsers like Chrome and Edge

  • Insurance verification

  • Typing 70 wpm,

  • Documentation and reporting

  • F

  • Aid in processing forms for hospitalized patients

  • Application management

  • Eligibility determination

  • Policy interpretation

  • Medicaid eligibility assessment

  • Effective team collaboration

  • Effective problem resolution

  • Reliability

  • Strong organizational abilities

  • Effective documentation practices

  • Medicaid

  • Application processing

  • Multitasking

  • Teamwork and collaboration

Timeline

Medicaid Eligibility Specialist

LewisGale Hospital Montgomery
02.2024 - Current

Financial Counselor

Lewis Gale Hospital Pulaski
06.2022 - 02.2024

Registrar II

Lewis Gale Hospital Pulaski
12.2016 - 06.2022

Diploma - Legal Secretary

Gadsden Business College

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Connie Spears