Darlene Washington
Pickens,MS
Overview
22
22
years of professional experience
1
1
Certification
Work History
Benefit Specialist Supervisor
Division of Medicaid
Yazoo City, MS
11.2022 - Current
- Assisted clients in understanding their benefits and eligibility criteria by providing detailed information and support.
- Developed and implemented strategies to ensure compliance with benefit regulations and policies.
- Monitored open enrollments to ensure accuracy of employee selections and that deadlines were met.
- Processed enrollment forms, changes in status forms, terminations and other benefit documents in a timely manner.
- Worked closely with human resources staff members to ensure that new hires receive necessary information about available benefits packages upon hire date.
- Coordinated benefits processing, including enrollments, terminations and claims.
- Reviewed employee enrollments to verify accuracy, inputting information into company database.
- Checked accuracy and completeness of benefits applications and documents.
- Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.
- Assisted with audits by preparing accounts and providing information.
- Tracked progress on projects and provided timely feedback to staff members.
- Resolved customer complaints in a timely manner while ensuring customer satisfaction.
- Monitored employee productivity to provide constructive feedback and coaching.
- Coordinated employee schedules according to shift changes and availability.
- Provided ongoing training to address staff needs.
- Reviewed completed work to verify consistency, quality and conformance.
Assistant Supervisor/Division Director I
Division Of Medicaid
Yazoo City, MS
07.2012 - 10.2022
- Resolved customer complaints promptly and effectively.
- Ensured safety regulations were followed at all times by employees.
- Trained new staff members on company policies, procedures and job expectations.
- Assisted in recruiting process by conducting interviews with prospective candidates.
- Collaborated with managers from other departments to ensure smooth workflow across the organization.
- Filed paperwork and submitted reports to upper management.
- Oversaw employee supervision, client satisfaction, contract management and daily work.
- Reviewed completed work to verify consistency, quality and conformance.
- Coached staff members to develop long-term career goals.
Medicaid Eligibility Specialist
Division Of Medicaid
Yazoo City, MS
01.2005 - 06.2011
- Conducted initial eligibility screenings for Medicaid applicants.
- Reviewed applications and supporting documents to determine applicant's eligibility for Medicaid benefits.
- Compiled and documented information regarding applicant's income, assets, insurance coverage and other relevant data.
- Verified accuracy of applicant's financial information against third-party sources such as employers, banks or government agencies.
- Processed requests for changes in existing Medicaid cases.
- Researched discrepancies between submitted forms and available records to ensure compliance with regulations.
- Maintained up-to-date knowledge of state and federal regulations pertaining to Medicaid eligibility.
- Responded promptly to inquiries from applicants, providers and other stakeholders concerning Medicaid services.
- Attended training sessions, seminars and workshops related to Medicaid programs.
- Collaborated with other departments within the organization in order to resolve issues relating to Medicaid eligibility requirements.
- Evaluated appeals of denied applications using established criteria.
- Established relationships with community organizations that provide assistance in obtaining health care services for low-income families.
- Assisted customers by phone and scheduled appointments.
- Maintained confidential clients documentation to prevent data compromise and comply with HIPAA regulations.
- Answered questions and responded to inquiries to deliver high level of service to clients.
Family Preservation Worker
Department of Human Services
Lexington , MS
06.2002 - 12.2004
- Conducted home visits and developed individualized service plans for clients.
- Assisted with parenting skills training, life skills development, and budgeting workshops.
- Facilitated weekly family meetings to identify problems, develop solutions, and monitor progress.
- Collaborated with community agencies to provide resources for clients' needs.
- Provided transportation assistance for medical appointments and other related activities.
- Maintained case records, wrote reports, and updated client information in database system.
- Supported clients in locating employment opportunities and job readiness programs.
- Monitored the safety of clients' homes by assessing potential risks or hazards present in the environment.
- Assisted the Social Workers in collaborating with other professionals such as psychiatrists, psychologists, and nurses to coordinate care for clients.
- Participated in court proceedings related to cases involving children or vulnerable adults.
- Assisted individuals experiencing homelessness by providing referrals for emergency shelter placements.
- Maintained thorough case history records and wrote detailed reports.
- Implemented social service interventions to achieve treatment goals and address client needs.
- Also facilitated Foster Parent Training classes.
Education
Bachelor of Arts - Sociology
Jackson State University
Jackson, MS05-2010
Bachelor of Arts - Social Work
Jackson State University
Jackson, MS05-2002
Skills
- Customer Service And Assistance
- Explaining Benefits
- Benefit Policy Interpretation
- Plan Administration
Certification
- Certified in State Basic Supervisor Course
- Leadership Development Training
Timeline
Benefit Specialist Supervisor
Division of Medicaid
11.2022 - Current
Assistant Supervisor/Division Director I
Division Of Medicaid
07.2012 - 10.2022
Medicaid Eligibility Specialist
Division Of Medicaid
01.2005 - 06.2011
Family Preservation Worker
Department of Human Services
06.2002 - 12.2004
Bachelor of Arts - Sociology
Jackson State University
Bachelor of Arts - Social Work
Jackson State University
- Certified in State Basic Supervisor Course
- Leadership Development Training
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