Jill Sweat, MBA
Dallas,GA
Summary
Over 20 years of professional experience providing service delivery. Extensive background in Medicaid eligibility at State and Federal levels. Demonstrated a high degree of accuracy in agency management and document management systems. Strong networking capabilities with Federal, State, and local agencies. Independent self-starter with the ability to work well with other team members. Seasoned collaborator experienced in meeting needs, improving processes, and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Senior Consultant
Deloitte
06.2022 - Current
- Troubleshot issues by understanding issue, diagnosing root cause and coming up with effective solutions.
- Identified business issues through careful collaboration with key stakeholders.
- Prioritized project tasks depending upon key milestones and deadline dates.
- Evaluated clients' needs and created plan of action to provide solutions.
- Interfaces Team Lead for CHIP IT Transition initiative, communicating the 834 file with X12 Standard Guidelines.
- QAT and UAT Testing
- Use SQL at beginner level
- Participated in writing Change Requests, Level of Effort documents, and Design Specification Documents.
Business Analyst II
Conduent
12.2020 - 06.2022
- Support the Medicaid Interoperability/EHR (Electronic Health Record) Incentive program for 7 states and Georgia EVV (Electronic Visit Verification)
- Conducted User Acceptance Testing (UAT) for SLR (State Level Registry) releases
- Communicated requirements to state clients and Medicaid providers established by CMS regarding Meaningful Use (MU), ARRA (American Recovery and Reinvestment Act), and the HITECH Act
- Serve as Tier II escalation lead which entails monitoring Tier II escalations, working with providers to resolve/answer questions related to the Medicaid PI Program and/or GA EVV to ensure escalations are worked and completed in a timely manner
- Assist Medicaid providers via phone, email, and/or TEAMS call/screen share to resolve issues
- Conveyed objectives to Medicaid providers on how to utilize Health Information Technology (HIT)
- Applied problem-solving skills to analyze and resolve issues impacting business operations and goal achievement
- Produced accurate and timely collections reports, facilitating measurement, and engagement with state clients
- Reviewed contracts and agreements to identify potential risks and ensure Service Level Agreements (SLA) were met
- Promoted enterprise-level risk management practices and helped instill strong culture focused on protective policies and procedures.
Healthcare Representative, Team Lead
Change Healthcare
02.2016 - 12.2020
- Assessed information gleaned from interviews, educational, and medical records to identify clients' abilities, needs and eligibility for Federal and State programs (Disability, Medicaid, Medicare)
- Assisted in claim preparation and submitted claims to Social Security Administration and GA DFCS to ensure Medicaid approval, Medicare approval, and/or Disability payments if applicable
- Addressed employee and production issues to implement optimal resolutions, preventing wasted resources and maintaining schedules
- Consistently monitored and met monthly production goals
- Screened an average of 10 patients per day with weekly acceptance rate of 5-10 patients per week
- Built successful referral network of company representatives, third-party administrators, and benefits providers.
- Helped vulnerable individuals navigate complex healthcare system
Revenue Maximization Specialist/Medicaid Eligibility
Georgia Department Of Human Services
02.2004 - 02.2016
- Determined Medicaid Eligibility for pregnant women, children, families with children, women with breast and/or cervical cancer
- Regularly used web portals such as GA SHINES, GAMMIS, Web One, and GA Gateway to ensure claim accuracy and proper aid categories
- Maintained compliance with HIPAA regulations
- Analyzed court orders for IV-B (State) or IV-E (Federal) funding qualifications
- Conducted outreach events and public speaking engagements in large group settings and/or one-on-one
- Created and improved weekly/monthly reports to monitor productivity
- Updated physical records and digital files to maintain current, accurate, and compliant documentation
Education
Master of Business Administration - Business Administration And Management
Strayer University
Washington, DC2018
Bachelor of Science - Human Services
Kennesaw State University
Kennesaw, GA2013
Skills
- 834 File Process
- X12 Standards for Electronic Data Interchange
- Educating Consumers
- Production Monitoring
- Process Monitoring
- Public Speaking
- Document analysis
- Teamwork/Collaboration
- Case Management
- Relationship Development
- Data interpretation
- Participant screening
Certification
Adult and Child CPR & AED
Timeline
Senior Consultant
Deloitte
06.2022 - Current
Business Analyst II
Conduent
12.2020 - 06.2022
Healthcare Representative, Team Lead
Change Healthcare
02.2016 - 12.2020
Revenue Maximization Specialist/Medicaid Eligibility
Georgia Department Of Human Services
02.2004 - 02.2016
Master of Business Administration - Business Administration And Management
Strayer University
Bachelor of Science - Human Services
Kennesaw State University