Marlon Baptiste
Brooklyn,NY
Summary
Dedicated professional with a strong focus on customer service and project management. Expertise in resolving issues to enhance satisfaction and streamline processes, contributing to organizational growth. Proven ability to leverage software tools for efficiency and maintain data integrity.
Overview
25
25
years of professional experience
Work History
Self-Employed
Self-employeed
Brooklyn, New York
01.2019 - Current
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Identified needs of customers promptly and efficiently.
- Assisted with customer requests and answered questions to improve satisfaction.
- Approached customers and engaged in conversation through use of effective interpersonal and people skills.
- Maintained updated knowledge through continuing education and advanced training.
- Utilized various software and tools to streamline processes and optimize performance.
- Updated and maintained databases with current information.
Reconciliation Analyst
HIP Health Plan of NY
New York, USA
10.2001 - 01.2019
- Reconciled membership data discrepancies between HCFA and Qcare records to ensure data integrity.
- Investigate and verify all documentation to be submitted to CMS for payment.
- Developed and implemented monthly audit process with claims department, ensuring accurate coordination of benefit claim payments.
- Utilize system to review and identify discrepancies and refer corrections to the appropriate internal departments.
- Accurate preparation and processing of the Medicaid and Institutional submissions.
- Meet all CMS and HIPAA guidelines and regulations.
- Involuntary member disenrollment, post membership appeals, letters and a host of other HCFA related compliance issues.
- Converted data into structured reports and PowerPoint presentations for clear communication.
- Assisted in recovering US 80 million in retro revenue through detailed analysis and collaboration with stakeholders.
Education
Business Administration -
Long Island University
New York08-2026
High School Diploma -
Bishop Ford High School
New York06-1998
Skills
- CMS
- QCare
- Data Management
- EMedNY
- EPaces Databases
- Market Analysis
- Project management
- Clerical support
- MS office
- Customer service
- Team collaboration
- Positive attitude
Timeline
Self-Employed
Self-employeed
01.2019 - Current
Reconciliation Analyst
HIP Health Plan of NY
10.2001 - 01.2019
Business Administration -
Long Island University
High School Diploma -
Bishop Ford High School