James E. Villeneuve Jr.
Albany
Summary
Highly skilled Agent with a background in managing complex transactions, communicating issues effectively within OMH and outside State agencies. Possess strong customer service skills, ability to handle high-pressure environments and maintain confidentiality. Demonstrated success in building trustful relationships with clients, and ensuring customer satisfaction. Have contributed significantly to previous work environment through strategic planning and efficient problem-solving abilities.
Overview
12
12
years of professional experience
Work History
Resource & Reimbursement Agent
NYS Office of Mental Health
Albany
04.2020 - Current
- Oversee the suspension of OMH Medicaid cases.
- Welfare Management System (WMS) subject matter expert
- Work directly with the NYS Department of Health on issues and resolutions to complicated problems with Medicaid cases.
- Analyze and resolve issues with Medicaid for the five field office issues.
- Ensure compliance with HIPPA, Department of Health (DOH) policies & OMH procedures.
- Thoroughly review, process, and submit Medicaid applications to DOH. Follow the cases to ensure adequate coverage is established and timely.
- Support field staff with policy-related questions and procedural issues.
- Prioritize work based on the level of importance, urgency, and timelines.
- Add content, update, and edit information in SharePoint/TeamSite.
Program Aide
NYS Office of Mental Health
Albany
11.2015 - 03.2020
- Analyze Medicaid transactions to resolve field office issues.
- Monitor spreadsheets for admission and discharge movements and take appropriate actions.
- Ensure compliance with HIPPA, Department of Health (DOH) policies & OMH procedures.
- Research Fair Hearing requests and keep accurate records.
- Thoroughly review, process and submit Medicaid applications to DOH. Follow the cases to ensure adequate coverage is established timely.
- Support field staff with policy related questions and procedural issues.
Tax Compliance Representative 1
NYS Taxation and Finance
Albany
03.2014 - 11.2015
- Handle large volume of incoming and make outgoing phone calls to resolve tax debts, address missing tax returns, and inform taxpayers of errors on filed returns.
- Explain the collection process; access taxpayer information to provide detailed explanations of assessments.
- Make account adjustments, process payments, and refunds; update taxpayer account information; answer questions concerning the provisions and requirements of the Tax or Labor Law.
Eligibility Specialist 2
Maximus Inc.
Albany
09.2013 - 03.2014
- Maintain an understanding of the NY Heath Benefit Exchange enrollment and eligibility processes and policies. Including individual and small business market policies.
- Utilize the best practice to obtain required documentation to resolve problems.
- Create payment plans for delinquent accounts.
Education
Associate Degree - Business
Bryant & Stratton College
08.2006
Skills
- Medicaid compliance
- Data analysis
- Policy interpretation
- Case management
- SharePoint management
- Communication skills
- Problem solving
- Attention to detail
- Time management
- Customer service
- Team collaboration
- Regulatory compliance
- Documentation accuracy
- Interpersonal skills
- Recordkeeping proficiency
- Report creation
- Positive attitude
- Teamwork and collaboration
- Organizational skills
- Microsoft office
- Internet savvy
- Task prioritization
- Documenting information
- Problem-solving skills
Timeline
Resource & Reimbursement Agent
NYS Office of Mental Health
04.2020 - Current
Program Aide
NYS Office of Mental Health
11.2015 - 03.2020
Tax Compliance Representative 1
NYS Taxation and Finance
03.2014 - 11.2015
Eligibility Specialist 2
Maximus Inc.
09.2013 - 03.2014
Associate Degree - Business
Bryant & Stratton College