MONIQUE FRAZIER
Orangeburg,SC
Summary
Healthcare Administrative Professional experienced in Medicaid eligibility, insurance benefits verification, claims support, and electronic case documentation. Delivered effective support for high-volume workloads while coaching new hires and assisting members and providers in remote settings. Focused on ensuring compliance with healthcare regulations through accurate documentation and coordination with specialty pharmacies.
Overview
1
1
Certification
4
4
years of post-secondary education
9
9
years of professional experience
Work History
Program Specialist
TEK SYSTEM
09.2026 - Current
- Review patient applications and program eligibility; assist with prior authorizations and alternate funding options.
- Coordinated prescriptions, product requests, and shipment tracking with specialty pharmacies and distributors to streamline delivery processes.
- Verified insurance coverage for prescribed therapies and explained benefits and assistance options to enhance patient access to necessary treatments.
- Documented patient and provider communications, followed up on outstanding information, and referred issues to appropriate teams to ensure timely resolution.
- Worked remotely from home to manage tasks and communications effectively.
Eligibility Analyst / Coach
PACER Staffing
09.2023 - 01.2026
- Reviewed high-volume Medicaid caseload, verifying income, residency, household composition, and insurance information to ensure accurate eligibility determinations.
- Handled inbound and outbound calls with applicants, providers, and insurance companies to clarify requirements and obtain needed information.
- Managed inbound and outbound calls with applicants, providers, and insurance companies to clarify requirements and gather essential information for case processing.
- Trained new hires on eligibility workflows, case-processing procedures, and documentation standards to enhance team competency.
- Collaborated with team members remotely to ensure efficient task management and communication. to manage tasks and communications effectively.
Tax Preparer – Seasonal
H&R Block
01.2018 - 04.2025
- Reviewed financial documents and entered client information to prepare accurate federal and state tax returns, ensuring compliance and maximizing client refunds.
- Identified and corrected document discrepancies to maintain accuracy and protect confidential client information.
- Clarified tax forms for clients during consultations and filing requirements, enhancing client understanding of returns and fostering trust.
- Explained tax forms and filing requirements so clients understood their returns.
Customer Service Representative
VDART
03.2021 - 09.2023
- Assisted 40+ members daily with healthcare benefits, eligibility decisions, and application requirements, enhancing member understanding in a remote environment.
- Handled inbound and outbound calls regarding billing, benefits, claims, eligibility, referrals, and treatment plans, ensuring accurate information delivery.
- Followed up with clients on claims questions, required documents, and appointment-related next steps.
- Followed up with clients on claims questions and required documents, facilitating timely resolution of appointment-related next steps.
- Worked in a remote setting to assist clients
Human Service Specialist (MAGI)
South Carolina Department of Health and Human Services
07.2018 - 03.2019
- Evaluated Medicaid applications and supporting documents, ensuring compliance with Modified Adjusted Gross Income (MAGI) guidelines to facilitate timely eligibility determinations.
- Verified applicant information and maintained accurate state eligibility records, contributing to reliable data management and client support.
- Explained benefit decisions and program requirements to clients, providing clear next steps to enhance understanding and engagement in the process.
- Assisted Medicaid providers with questions about coverage, eligibility, enrollment, claims, and reimbursement.
Medical Office Assistant – Internship
Orangeburg Medical Association
, PA
05.2018 - 07.2018
- Updated electronic medical records and prepared patient charts to enhance accuracy and accessibility for clinical staff.
- Scanned, organized, and filed documents to maintain comprehensive medical records and facilitate efficient retrieval.
- Verified insurance eligibility and assisted patients with registration and scheduling to streamline the patient intake process.
- Scanned, organized, and filed documents to keep medical records complete and easy to retrieve.
Education
Bachelor of Science - Health Information Management
DeVry University
Lisle, IL 01.2025 - 10.2026
Associate of Applied Science - Medical Reimbursement & Coding
Bryant & Stratton College
Orchard Park, NY 11.2015 - 01.2018
Skills
- Medicaid Eligibility & Case Processing
- Insurance & Benefits Verification
- Prior authorization
- Insurance verification
- EHR/EMR Systems
- Electronic health records
- Medical Records
- Case Tracking
- Provider & Member Support
- New hire onboarding
- Microsoft Office Suite
- Remote Work
- HIPAA & Confidentiality
Certification
Medical Billing and Electronic Health Records | ed2go | September 2026 – Present, Pharmacy Technician Training & Registration | Patch Career Institute | 2025, Medical Billing & Coding | Patch Career Institute | 2025, Medical Office Administration Certificate | New Horizons | 2020, Notary Public | Commission expires April 10, 2028
Timeline
Program Specialist
TEK SYSTEM
09.2026 - Current
Bachelor of Science - Health Information Management
DeVry University
01.2025 - 10.2026
Eligibility Analyst / Coach
PACER Staffing
09.2023 - 01.2026
Customer Service Representative
VDART
03.2021 - 09.2023
Human Service Specialist (MAGI)
South Carolina Department of Health and Human Services
07.2018 - 03.2019
Medical Office Assistant – Internship
Orangeburg Medical Association
05.2018 - 07.2018
Tax Preparer – Seasonal
H&R Block
01.2018 - 04.2025
Associate of Applied Science - Medical Reimbursement & Coding
Bryant & Stratton College
11.2015 - 01.2018