MATTHEW WILLIAMS
Murfreesboro,TN
Summary
Hard-working individual with a knack for customer service and growth/development. Devoted to providing high quality cost-effective care to Tennessee residents.
Overview
6
6
years of professional experience
Work History
Regular Program Specialist
Division of Tenncare, Eligibility Operations Group
07.2021 - Current
- Processes cases within the Case Maintenance, Regular Renewal Authorization, Regular Renewal Case Change queue, and Secondary Review queues.
- Worked/assisted with projects and reports including the Business Exception Report, UAT Testing, Cases Without Renewal Report, Override Report, Conversions Project, and Case Merge Report.
- Responsible for adding and ending overrides for team members.
- Provides consultation and advice relating to federal and state health policies to internal and external partners, applicants and other interested stakeholders.
- Works to ensure accuracy of case information to determine the correct disposition on cases.
- Interprets policy and processing documentation to decide the best course of action for cases.
- Attend meetings regularly including weekly team meetings, monthly unit meetings, and weekly drop-in meetings to expand knowledge.
- Attended meetings for modifying the Case Reading Tool and currently selected to attend quarterly TEDS Workgroup meetings to discuss TEDS issues.
- Trained and advised new hires on how to process cases.
- Utilizes systems/programs such as TEDS, MMIS/Interchange, ServiceNow, Microsoft Office Suite while processing cases to do further research on issues, and file and track tickets to escalate issues.
- Was given the rating of Subject Matter Expert during the employee proficiency assessment.
- Identifies inconsistencies and errors in policies, rules, procedures and suggest corrective action to management.
- Collaborates with team members often to determine the best course of action on case issues that arise.
- Maintains professional working relationships with peers and with upper management to ensure smooth and effective team operations.
- Verifies the accuracy and completeness of information received, and ensures that it is processed within required time frames.
Error Processing Analyst
Division of Tenncare, Compliance and Policy Group
11.2019 - 07.2021
- Reviewed error reports to improve the design and integrity of the report and to resolve issues within TEDS and MMIS including business exceptions that prevent automated updates and processing, coverage overlaps, improper terminations, gaps in coverage, date of death information, and issues with overrides.
- Kept track of information concerning TEDS data fixes and dates when updates are made in TEDS.
- Using information about data fixes, updates in TEDS, and batches to interpret the occurrence of errors as they hit reports and surface from the Business Support inbox.
- Responsible for filing, tracking, and escalating case and TEDS issues for resolution and to improve the functionality of TEDS.
- Communicated with Deloitte and other units within TennCare to effectively solve errors and various issues that arise.
- Reviewed cases in the business support inbox to advise workers and determine the best course of action for resolution.
- Attended regular meetings such as weekly team meetings, weekly reports meetings, weekly UAT meetings, weekly infrastructure meetings, weekly data fix meetings, and weekly meetings with Deloitte to discuss issues and errors that needed resolved.
- Along with TEDS, MMIS/Interchange, Microsoft Office Suite, and ServiceNow, I also utilized systems such as Jama, JIRA, and Tableau to carry out my daily work duties.
- Used multiple sources of information to exercise sound judgement when reviewing errors and issues.
- Conducted a variety of meetings to provide and gather status updates for assigned workload.
- Provided updates to assigned supervisor to ensure accurate and timely receipt of instructions and work assignments for reports including the Business Exception Report.
- Facilitated, developed and maintained working relationships with team members to enhance productivity and effectively serve customer needs and promote self sufficiency within the work unit.
- Compiled and edited reports to be worked for teams within the Eligibility Operations Group.
- Analyzed errors identified through electronic process and assigns to peers/subordinates to resolve issues in order to complete enrollment in the HCFA/TennCare program.
- Conducted or lead in efforts to ensure the resolution of errors and completion of projects.
- Responded to emails, telephone calls, and other correspondence in a timely fashion.
Legal Assistant
KHI Knowledge Service/Division of Tenncare
11.2018 - 11.2019
- Used software and systems such as MMIS/Interchange, TEDS, and Maximus to determine eligibility and to streamline the eligibility process for applicants and recipients
- Used Microsoft Office Suite to complete assignments and projects given by supervisors
- Made outreach calls to members to complete Renewal and applications over the phone and to receive vital information needed for coverage determination.
- Register applications in a precise and prompt fashion to help streamline the process of determination
- Attended trainings to gain knowledge on procedure, software implementation, and policy.
- Used resources such as peers, policy documents, notes, meetings, and TEDS Help function to stay current with important information and to process cases.
- Collaborated with teammates and peers on various projects assigned by supervisor and executive team.
- Maintained a customer focus both internally and externally to effectively address needs.
- Maintained working knowledge of Tenncare policy, TEDS functionality, and MMIS/Interchange functionality.
Education
BBA - Business Management, Business Administration
Middle Tennessee State University
Murfreesboro, TN05.2027
Associate of Science - Accounting
Motlow State Community College
Lynchburg, TN05.2015
Skills
- Proficient in eligibility determination and error analysis
- Seeks to build skills
- Ability to multi-task
- Proven ability to work efficiently and
effectively on a consistent basis - Time management skills
- Ability to learn and adapt in a fast-paced working environment
- Determined and persistent
- Strong work ethic
- Verbal/written Skills
- Detailed-oriented/Seeks quality work
- Coachable
- Knack for learning
- Tennessee Eligibility Determination System competency
- Medicaid and Medicare Information System competency
- Seeks to build collaborative relationships
- Policy knowledge
Affiliations
- LaCherelle Mormon- Regular Programs Manager; phone number- (256) 651-8903
- James Brown- Business Improvement Liaison; phone number- (615) 663-3013
- Marvin Gardner- Regular Programs Specialist; phone number- (931) 434-3582
Timeline
Regular Program Specialist
Division of Tenncare, Eligibility Operations Group
07.2021 - Current
Error Processing Analyst
Division of Tenncare, Compliance and Policy Group
11.2019 - 07.2021
Legal Assistant
KHI Knowledge Service/Division of Tenncare
11.2018 - 11.2019
BBA - Business Management, Business Administration
Middle Tennessee State University
Associate of Science - Accounting
Motlow State Community College
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