Cynthia Peet
Hemphill
Summary
Dedicated Eligibility Advisor II with a proven track record in effective communication and client relationship management. Expertise in regulatory compliance and analytical thinking enhances problem-solving capabilities.
Overview
29
29
years of professional experience
Work History
Eligibility Advisor II
HHSC
Hemphill
09.2022 - Current
- Provided expert guidance on client inquiries and concerns.
- Interviewed clients to obtain information about employment history, educational background, relationships, resources to include vehicles and liquid assets.
- Use CAPPS, PALMS, EWMS, State Portal, Data Broker on or nearly on a daily basis for client records, training and leave requests/OT hours.
- Participate and complete all required training courses
- Process FS benefits, CMA, MA-TANF Level Families applications and redeterminations by following requirements and policies.
- I follow the HIPPA and Tax Sensitive information regulations.
- I do handle and resolve complex case issues with limited assistance.
- To my knowledge, I have not received any complaints regarding my customer service skills. I do develop and establish working relationships with my coworkers and supervisors.
- I do work 20 hours of OT a month mandated by the state.
- I did start off as an Eligibility Advisor I in September 2022 and was promoted to an Eligibility Advisor II in September 2023.
Program Specialist
Michael E. DeBakey VA Medical Center
Houston
02.2011 - 02.2020
- Coordinated program activities for veterans' healthcare services and resources.
- Developed training materials for staff on program policies and procedures.
- Facilitated workshops to enhance veteran engagement and participation in programs.
- Analyzed program data to identify areas for improvement and efficiency.
- Collaborated with multidisciplinary teams to address veteran needs effectively.
- Ensured compliance with federal regulations governing veteran services programs.
- Collaborated with other departments within organization on cross-functional projects.
- Identified opportunities to improve or enhance program initiatives and operations.
- Provided guidance to new staff members about their roles and responsibilities within the organization's programming framework.
- Participated in team-building exercises that fostered collaboration among staff members working on the project.
- Provided technical support to staff members regarding the use of software programs related to the project.
- Identified opportunities for improvements in existing processes or policies related to program operations.
- Developed and delivered educational and informational presentations on program initiatives.
- Compiled reports summarizing progress towards goals and objectives of the initiative.
- Gathered statistical data and wrote reports on program outcomes.
- Coordinated resources for program implementation, including personnel and materials.
- Facilitated communication between departments to ensure timely completion of projects.
- Prepared periodic reports, financial statements and records on program activities for management.
- Oversaw the development and distribution of program materials, ensuring quality and accuracy.
- Implemented tracking systems for participant engagement, enhancing program effectiveness.
- Maintained comprehensive databases of participants, activities, and outcomes for reporting purposes.
- Managed volunteer recruitment, training, and assignments to support program initiatives.
- Assisted in the creation and revision of program policies and procedures to ensure compliance.
- Adapted programs in response to participant feedback and changing needs.
- Analyzed data to assess program impact and to guide strategic planning.
- Maintained positive working relationship with fellow staff and management.
- Identified needs of customers promptly and efficiently.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Set specific goals for projects to measure progress and evaluate end results.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Implemented strategies to take advantage of new opportunities.
- Evaluated needs of departments and delegated tasks to optimize overall production.
- Analyzed key performance indicators to identify effective strategies.
- Monitored operations and reviewed records and metrics to understand company performance.
- Assessed company operations for compliance with safety standards.
- Created plans to propose solutions to problems related to efficiency, costs or profits.
- Oversaw quality control to identify inconsistencies and malfunctions.
- Organized client meetings to provide project updates.
Credentialing Supervisor
Michael E. DeBakey VA Medical Center
Houston
12.1996 - 02.2011
- Supervised credentialing processes for healthcare professionals at VA Medical Center.
- Managed team of credentialing specialists to ensure compliance with regulations.
- Reviewed and verified credentials, licenses, and certifications for staff members.
- Coordinated training sessions to enhance team knowledge on credentialing standards.
- Developed procedures for efficient processing of applications and renewals.
- Implemented quality control measures to maintain accuracy in credentialing records.
- Facilitated communication between departments regarding credentialing requirements and updates.
- Analyzed trends in credentialing processes to improve operational efficiency at facility.
- Served as a liaison between providers and external entities such as state licensing boards or national organizations.
- Developed strategies for streamlining Credentialing operations while maintaining quality standards.
- Created reports regarding various aspects of the credentialing program such as license expirations or privileging status updates.
- Attended continuing education programs related to healthcare regulation or administrative best practices.
- Provided reports to department directors regarding credentialing activities or trends in provider data changes.
- Assisted with the maintenance of databases for provider information.
- Performed audits of credentialing files to ensure accuracy and completeness of documentation.
- Collaborated with departments throughout organization to ensure consistency in provider data across systems.
- Conducted credentialing applications, verifications, and renewals for medical staff.
- Coordinated meetings with providers to discuss any issues that arise during the credentialing process.
- Verified licensure, education, certification, malpractice insurance coverage, and other documents as required by accreditation standards.
- Developed and monitored policies and procedures related to the Credentialing process.
- Researched discrepancies in background checks or other verification processes when needed.
- Responded promptly to inquiries from internal departments regarding provider information or status changes.
- Trained new employees on Credentialing processes and procedures.
- Participated in accreditation surveys conducted by outside agencies such as The Joint Commission.
- Reviewed credentials in a timely manner ensuring accuracy and compliance with regulatory requirements.
- Monitored expiration dates for professional licenses, certificates, degrees to ensure renewals are completed prior to expiration date.
- Ensured compliance with applicable laws, regulations, policies, procedures, and contracts related to Credentialing functions.
- Maintained files on all providers including current licenses and certificates of insurance.
- Performed primary source verifications such as criminal histories, licenses and board certifications.
- Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
- Checked applications for missing information and organized all paperwork.
- Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries.
- Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
- Performed database queries, compiling information according to requests and logging logistics changes.
- Organized records to prepare for site visits by representatives and associated audits.
- Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
- Facilitated communication between departments to resolve credentialing issues efficiently.
- Addressed and resolved discrepancies in provider documentation during credentialing.
- Developed and implemented credentialing policies and procedures to improve workflow.
- Assisted in the accreditation process by gathering and submitting required documentation.
- Coordinated with healthcare professionals to collect necessary documentation for credentialing.
- Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
- Provided guidance and support to new providers throughout the credentialing process.
- Participated in credentialing committees, presenting cases and making recommendations.
- Collaborated with legal department to ensure compliance with federal and state regulations.
- Responded to verification inquiries from other healthcare organizations and insurance companies.
- Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
- Maintained up-to-date records of credentialing statuses in database systems.
- Updated credentialing software with new features to enhance process efficiency.
- Conducted regular audits of credentialing files to ensure accuracy and completeness.
- Trained junior credentialing staff on best practices and company-specific procedures.
- Prepared and submitted detailed reports on credentialing progress to management.
- Conducted thorough background checks and verified educational and professional qualifications.
- Delegated work to staff, setting priorities and goals.
- Resolved customer complaints or answered customers' questions.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Coordinated with other supervisors, combining group efforts to achieve goals.
- Guided employees in handling difficult or complex problems.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Discussed job performance problems with employees, identifying causes and issues to find solutions.
- Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules.
- Issued work schedules, duty assignments and deadlines for office or administrative staff.
- Reviewed employees' work to check adherence to quality standards and proper procedures.
- Reviewed reports on employee attendance, productivity and effectiveness to evaluate performance.
- Developed work schedules according to budgets and workloads, covering priority tasks.
- Interpreted and explained work procedures and policies to brief staff.
- Participated in subordinates' tasks to facilitate productivity or help overcome difficulties.
- Recruited, interviewed and selected employees to fill vacant roles.
- Recommended solutions related to staffing issues and proposed procedural changes to managers.
- Implemented departmental policies and standards in conjunction with management to streamline internal processes.
- Researched and prepared reports required by management or governmental agencies.
- Analyzed financial activities of department to share budgetary input with managers.
Education
Associate of Arts - Business
Houston Community College
Houston, TX12-2010
Skills
- Client interviews
- Case management
- Policy compliance
- Benefit processing
- Software utilization
- Program coordination
- Effective communication
- Problem solving
- Relationship management
- Analytical thinking
- Written communication
- Emotional intelligence
- Critical thinking
- Client relationship management
- Problem-solving
- Conflict resolution
- Empathy and understanding
- Time management
- Client engagement
- Customer service
- Decision-making
- Industry knowledge
- Regulatory compliance
- Solution-oriented approach
- Active listening
- Persuasion techniques
- Data interpretation
Timeline
Eligibility Advisor II
HHSC
09.2022 - Current
Program Specialist
Michael E. DeBakey VA Medical Center
02.2011 - 02.2020
Credentialing Supervisor
Michael E. DeBakey VA Medical Center
12.1996 - 02.2011
Associate of Arts - Business
Houston Community College