Joni James
Houma,LA
Summary
Resourceful Eligibility Specialist known for high productivity and efficient task completion. Possess specialized skills in
policy interpretation, needs assessment, and case management software proficiency. Excel in communication, empathy,
and problem-solving, ensuring successful navigation through complex eligibility criteria and enhancing client satisfaction.
Overview
20
20
years of professional experience
2005
2005
years of post-secondary education
Work History
Eligibility Specialist/Medicaid Representative
Exchange Support Services
Houma, Louisiana
11.2018 - Current
- Fully supports CrescentCare open access initiatives including same-day access to services.
- Demonstrate proficiency in applying for benefits, including, but not limited to RWB CERV, RWB LA HAP, SNAP, Unemployment, Medicaid, Marketplace, Medicare, and V.A.
- Demonstrate proficiency in assisting with submission and follow-up of eligible bills to RWB LA HAP and HIP
- Assisted clients in understanding program requirements and application processes.
- Processed applications and maintained accurate client records systematically.
- Collaborated with team members to enhance service delivery efficiency.
- Responded to inquiries regarding eligibility criteria and documentation needed.
- Reviewed case files for compliance with regulations and policy standards.
- Documented client interactions and updated information in management systems accurately.
- Develop and nurtures relationships with public and private benefit providers/outsource.
- Develop and maintain strong working relationships with and routinely consult with case managers, healthcare providers, psychiatrists, and health educators both within the agency and the community at large as to ensure smooth service transitions and adequate access to benefits for clients.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Inputted all communication with applicants into computer system to facilitate future clarification and knowledgeable support.
- Processed Medicaid applications efficiently and accurately for diverse populations.
- Educated clients on Medicaid eligibility requirements and application procedures.
- Maintained up-to-date knowledge of Medicaid policies and regulations.
- Communicated with healthcare providers to resolve billing and coverage issues.
- Prepared detailed reports on client data, including demographic information, financial status, health care needs.
- Maintained an up-to-date understanding of federal and state laws governing Medicaid services.
- Reviewed medical documentation submitted by providers in order to determine whether services were medically necessary or appropriate for reimbursement under the program guidelines.
Behavior Specialist
Restore Outreach Center
Houma, Louisiana
02.2016 - 12.2018
- Provide crisis counseling and intervention to students.
- • Evaluate students' abilities interests and personality characteristics to
- determine strengths and deficits using assessments tests and interviews.
- • Develop therapeutic treatment plans according to clients' needs and
- i n t e r e s t s .
- • Work in collaboration with school instructors and community agencies to
- secure services a n d resources for students.
- • Developed and implemented departmental support systems to meet
- strategic objectives.
- • Devised and implemented individualized professional learning resources,
- systems and coursework to boost teaching aptitudes.
- • Eliminated learning gaps and effectively instructed students by developing
- IEPs and using wide variety of teaching aids and motivational strategies.
Student Services Coordinator
Blue Cliff College
Houma, Louisiana
09.2017 - 11.2018
- Identify community resources for at risk students.
- • Work with faculty and staff to incorporate students' interests into
- instructional material.
- • Model healthy problem resolution techniques for high risk students.
- • Insure early academic success by developing and implementing
- recognition and rewards programs.
- • Oversaw tutoring program focused on helping students of all levels excel
- i n coursework
- • Improved measurements, performance metrics and overall student success
- by defining and articulating learning outcomes.
- • Answered student, family and visitor questions with friendly and
- knowledgeable support.
- • Helped students build social, emotional and academic skills.
Physical Therapist Assistant
TGMC Inpatient Rehabilitation
Houma, Louisiana
01.2011 - 08.2017
- Provided care to patients by working cooperatively with other team
- members in maintaining standards of care in the clinical setting.
- • Demonstrated proficiency in recording patient medical histories and vital
- signs, as well as in performing injections and various diagnostic
- procedures and ancillary tests.
- • Assisted patients with orthopedic and neurological disorders with
- activities of daily living.
- • Created individualized exercise programs for patients while working in an
- acute care setting.
- • Recorded detailed prognosis, treatment, responses and progress notes in
- patient charts.
- • Ensured HIPAA rules and regulations were carefully followed.
- • Administered simple range of motion exercises.
- • Instructed patients on proper hygiene, nutrition, exercise, lifestyle changes
- and ergonomic factors in daily activities.
Families Case Worker
Start Corporation
Houma, Louisiana
01.2013 - 11.2015
- Worked with clients to obtaining permanent housing.Facilitated the learning of basic budgeting skills to veterans
Provided referrals to families and children for behavioral health services.
Worked towards securing supplemental income, other state funded and
veteran's benefits for veterans
Conducted outreach to local community leaders and progressive organizations and assisted with local and regional on-site events.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Maintained industry knowledge through continuing education, training and monitoring of industry publications.
Mortgage Loss Mitigation Specialist
Bank of America Corp.
Addison, Texas
07.2009 - 10.2009
- Analyzed customer accounts for potential loss mitigation strategies.
- Collaborated with clients to develop tailored repayment plans.
- Evaluated loan modifications and hardship documentation for approval.
- Managed case files and maintained accurate customer records.
- Provided training sessions for new team members on processes.
- Reviewed compliance regulations to ensure adherence in operations.
- Coordinated with internal departments to streamline loss mitigation processes.
- Determined level of acceptable risk by reviewing applications for coverage and loss control reports.
- Served as liaison between borrowers and lenders and collaborated with both parties to obtain optimal loans for home purchases.
- Verified income of borrower and gathered credit information. Parties, resolved calls at the first point of contact when responding to incoming phone calls, resolved payment issues on a timely basis, such as delinquent government and conventional mortgage loans, handled customer complaints and document generation, updated account and research disputed items and other inquiries and skip tracing, provided data on status, transaction or account activity, maintained customer inquiries when loans are in Ch. VII bankruptcy or foreclosure.
Back-End Collector-Team Leader
Drive Financial
Dallas, Tx
05.2008 - 10.2009
- Managed collection activities to recover outstanding debts from clients.
- Communicated with customers to establish payment arrangements and resolve disputes.
- Utilized company software to track account statuses and collection efforts. helped lead a team of 20 employees with meeting our goals each month, and helped to make decisions with calls when the manager was unable to make them.
- Collaborated with team members to improve collection processes and strategies.
- Documented interactions with clients in compliance with company policies.
- Maintained detailed records of collection activity in database system.
- Researched public records such as liens, judgments, bankruptcies for collection purposes.
- Investigated customer disputes regarding billing errors or incorrect payments received from customers.
Administration Assistant-Collector
LA Fitness Corp.
Carrollton, Texas
12.2007 - 05.2008
- Managed daily office operations and ensured efficient workflow across departments.
- Coordinated schedules and meetings for team members and management staff.
- Assisted in preparing reports and presentations for internal and external stakeholders.
- Answered incoming calls in a professional manner.
- Managed physical and digital files, monitored spreadsheets, and updated reports to coordinate project materials.
- Tracked and submitted employee timesheets to prepare for payroll processing.
- Tracked project performance data to generate reports and keep management informed of important trends.
- Managed office supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing orders; verifying receipt of supplies.
- Answered phone calls and emails to provide information, resulting in effective business correspondence.
- Created spreadsheets in Microsoft Excel for record-keeping and reporting.
- Updated system to organize office documentation, maximizing efficiency and increasing productivity.
Customer Service Representative-Skip Tracer
Capital One Auto Finance
Plano, Texas
01.2006 - 10.2007
- Assisted customers with inquiries regarding auto financing options and services.
- Resolved customer complaints through effective communication and problem-solving skills.
- Educated clients on payment processes and account management tools. Promoted to the customer service desk tier 3 - responsible for customer relations, accounts receivables, and accounts payable, assisted with outbound calls to clients that were behind on payments, made adjustments on accounts that were delinquent, handled customer complaints upon request, handled outstanding accounts that were out for repo., used proper guidelines in order to skip trace our clients.
- Handled sensitive customer information while ensuring compliance with privacy regulations.
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Education
Ellender M. High School
Houma, LASome College (No Degree) - General Studies
Delgado Community College
New Orleans, LASkills
- Skip Tracing Applicant support and service Collections/Customer Service Application assessment MS Word/Outlook Record-keeping and data input MS Office/Excel Telephone etiquette MS PowerPoint Advocacy and Counseling Internet Inbound and outbound calling Medicaid application Strong communication skills Benefit determination Account receivable/account payable Case management Flexible schedule Medicaid
- Medicaid processing
Timeline
Eligibility Specialist/Medicaid Representative
Exchange Support Services
11.2018 - Current
Student Services Coordinator
Blue Cliff College
09.2017 - 11.2018
Behavior Specialist
Restore Outreach Center
02.2016 - 12.2018
Families Case Worker
Start Corporation
01.2013 - 11.2015
Physical Therapist Assistant
TGMC Inpatient Rehabilitation
01.2011 - 08.2017
Mortgage Loss Mitigation Specialist
Bank of America Corp.
07.2009 - 10.2009
Back-End Collector-Team Leader
Drive Financial
05.2008 - 10.2009
Administration Assistant-Collector
LA Fitness Corp.
12.2007 - 05.2008
Customer Service Representative-Skip Tracer
Capital One Auto Finance
01.2006 - 10.2007
Ellender M. High School
Some College (No Degree) - General Studies
Delgado Community College