LISA ATKINS
Carthage,NC
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience. Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking entry-level opportunities to expand skills while facilitating company growth. Understanding Enrollment Specialist in AlphInd, Committed to engaging customers to help each understand the value of programs and services. Adept at performing key administrative tasks in support of enrollment procedures. Strong coordination and leadership skills with the ambition to persevere.
Overview
10
10
years of professional experience
Work History
MEMBER ELIGIBILITY & ENROLLMENT SPECIALIST
Sandhills Center LME-MCO
WEST END, NC
11.2013 - Current
The primary propose of this position is to provide non-clinical administrative support of data entry for Customer Service Department. This positions:
Accesses, processes, and enters structured clinical and non-clinical data.
Reviews data and information for completeness of information.
Enrolls members and inpatient admissions.
Submits and updates Client Data Warehouse (CDW) elements.
Tracks data, maintains databases, and processes data for reporting.
Check member eligibility status as a payer, residence, and other structured criteria.
Attendee\participant of AlphaInd (AlphaMCS)Teams, and Clinical\Financial High Risk Management Meetings, SME Group for Member Eligibility and Enrollment, CDW Double Numbers Work Group and Core Team Calls.
Review\audit AlphaInd and work with other departments in the agency to correct AlphaInd errors.
Attend and participate in Provider Orientations and AlphaInd Trainings.
Assist ME&E Coordinator with preparing information for Providers as well as composition of ME&E procedures.
Subject Matter Expert (SMEs) on the AlphaInd system which includes testing functionality of new and updated software and trouble shooting errors.
Generate reports daily from NC Tracks to correct erros.
Work closely with Claims\Finance to ensure claims process, correct Target Pops and name mismatches, etc.
Research and identify duplicate record numbers and review errors on CDW reports on multiple CDW reports to include Missing Diagnosis, SA Drug of Choice, SA Missing Activity, Unknown Race, Ethnicity and Unknown Family Income as these are required fields for CDW.
Assist Providers with Enrollments, Client Update (CURs) and SAR\Auths questions.
On days the office is closed ( Holidays & Weekends) process hospital admission and Client Updates.
Work closely with our IT and BI departments to create new reports\queries gathering and processing information to ensure accuracy between AlphaInd, NC Tracks and CDW.
Make corrections of duplicate diagnoses and duplicate drug of choice information.
Access NC Tracks to assign new CNDS#'s.
Maintain admissions of members\recipients admitted to the hospitals in several databases. This information is utilized by Care Coordination staff.
Education
High School Diploma -
Spencer High School
Spencer, WV06-1989
Skills
- Data Entry Skills
- DMH Recipient Eligibility Error Report
- DMH Recipient Edit Error Report
- DMH Recipient Demographic Data Discrepancy Report
- DMH Recipient Eligibility Update Report, 834
- Internet
- NC Tracks
- Databases
- Spreadsheets
- AlphaInd
- Copies, fax machine, general office supplies, etc
- Computer skills, duel monitors
- Customer Service
- SCH Learning Management ( required training )
- Enrollments and Client Update assignments
- Provider Relations
- Telephone and Email Skills
- Excell
- MicroSoft
- Teams Management System
Timeline
MEMBER ELIGIBILITY & ENROLLMENT SPECIALIST
Sandhills Center LME-MCO
11.2013 - Current
High School Diploma -
Spencer High School
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