Debra Huesser
West Deptford,NJ
Summary
Bilingual, solution-oriented professional, with proven track record of effective client service delivery seeking to provide quality leadership, communication, and administration.
Overview
6
6
years of professional experience
Work History
Appeals Specialist Caseworker III
Early Learning Resource Center
Upper Darby, PA
01.2023 - Current
- Assistant supervisor duties in department
- Advised customers on best practices for submitting complete documentation along with their appeal requests
- Analyzed documents submission to determine if further information was needed to process appeals
- Identified reasons behind Adverse Actions and worked closely with clients and regulations to promote resolutions
- Monitored cases to identify timely solutions on issues, Conducted quality assurance reviews of other caseworkers work product to ensure state regulation adherence
- Participated in training sessions on new rules or regulations affecting the appeals process
- Assisted in developing departmental goals as well as individual performance objectives
- Liaison for Spanish speaking demographic community
- Received and submitted Intercounty Transfers of client's cases ensuring continuous eligibility.
Provider Specialist II
Early Learning Resource Center
Upper Darby, PA
05.2020 - 01.2023
- Translated and transcribed enrollment summaries and confirmation letters for Spanish-speaking families
- Acted as liaison between regulated providers, relative providers and Delaware County officials for invoicing issues and enrollment errors
- Facilitated meetings for Low-Income families and Temporary Assistance of Needy Families (TANF) Assisted newly certified daycare providers with contract processes with Delaware County
- Provided guidance for new clients with application procedures
- Adherence to State and federal guidelines in accordance with childcare and Early Learning Resource Program
- Provided referrals and resources to Low-income families within Delaware County for children such as WIC, CHIP and HeadStart.
Disability, Life and Health Insurance Contractor
Self Employed
04.2019 - 05.2020
- Kept clients informed about progress status updates throughout the entire process
- Resolved any problems encountered during the application process
- Visited job sites and reviewed appropriate products to ascertain proper application for the client
- Receipt of Leads from insurance carriers for client enrollments Procurement of health insurance for qualified individuals and coordination with families Provided explanation of Health Insurance Portability and Accountability Act as well as other federal and state guidelines
- Provided in-home counseling to customers and families on Medicare Advantage products, including covered and non-covered entities.
Provider Specialist II
Early Learning Resource Center
Upper Darby, PA
02.2018 - 10.2019
- Responded quickly to regulated and relative providers complaints using diplomatic communication to initiate problem resolution
- Facilitated communication between providers, clients, and the fiscal department
- Advised providers on changes in policy or procedure related to the processing of invoicing
- Monitored provider compliance with contractual agreements and standards of care
- Conducted audits of provider files to verify proper documentation is present prior to payment
- Attended meetings with potential relative provider
- Maintained accurate records of all provider interactions and transactions
- Answered telephones and directed calls to appropriate solutions
- Scheduled and confirmed potential relative provider for meetings to become eligible providers
- Prepared reports, invoices, letters, using word processing, spreadsheet, or other software applications.
Education
Bachelor of Science - Business Administration
Holy Family University
05.2015
Associate of Arts - Communications
Camden County College
05.2010
Skills
- Bilingual-Fluent in English and Spanish
- Strong Analytical Skills
- Effective Communication Abilities
- Problem-Solving Capabilities
- Strong customer service
- Leadership skills
Timeline
Appeals Specialist Caseworker III
Early Learning Resource Center
01.2023 - Current
Provider Specialist II
Early Learning Resource Center
05.2020 - 01.2023
Disability, Life and Health Insurance Contractor
Self Employed
04.2019 - 05.2020
Provider Specialist II
Early Learning Resource Center
02.2018 - 10.2019
Bachelor of Science - Business Administration
Holy Family University
Associate of Arts - Communications
Camden County College
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