Motivated professional with 6+ years of history meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges.
Overview
9
9
years of professional experience
Work History
Quality Control Analyst
Florida Department of Children and Families
03.2023 - Current
Conduct over 80 state and federally mandated case reviews monthly, such as Management Evaluation (ME) and Medicaid Eligibility Quality Control (MEQC) reviews.
Collect and analyze data from case reviews, providing corrective action guidance to improve accuracy threshold for Medicaid, SNAP, Temporary Cash Assistance (TCA), and Refugee Assistance Program (RAP).
Provide data for technical assistance in aiding the agency to reduce misspent funds.
Prepare and present guidelines and expectation of case review procedure to ESS staff across Florida.
Eligibility Specialist II
Florida Department of Children and Families
04.2020 - 03.2023
Collaborated with management to provide assistance and instructions to trainees and peers efficiently.
Completed monthly Medicaid and SNAP audit to determine error trend and recommendation to ensure quality service.
Conducted interviews for qualifying potential employees.
Determined eligibility for Family Medicaid, Emergency Medicaid for Non-Citizen, and Aged or Disabled Medicaid.
Eligibility Specialist I
Florida Department of Children and Families
08.2018 - 04.2020
Determined SNAP and Medicaid eligibility in accordance with current federal and state regulations for over 100 cases monthly.
Managed and organized assignments while ensuring cases are completed timely and accurately.
Authorized grant benefits by analyzing financial and family status.
Coordinated referrals and direct support for client needs.
Clinical Data Abstractor (Temp)
Envision Physician Services
01.2018 - 08.2018
Entered medical information of 160+ patients into EMR database, while maintaining departmental productivity and accuracy standards.
Monitored and provided feedback on medical record and documentation issues.
Assisted with other data collection and audit projects as needed.
Lead Patient Care Coordinator
Holy Cross Hospital
10.2016 - 12.2017
Optimized insurance claims processing by maintaining accurate and up-to-date patient information in electronic health records.
Supported clinical staff in providing exceptional care through seamless coordination of appointments, referrals, tests, and follow-up visits.
Trained new Patient Care Coordinators to ensure consistent quality of service across the team.
Increased staff productivity by coordinating schedules, delegating tasks, and monitoring performance metrics regularly.
Clinic Service Representative
Florida Orthopaedic Institute Urgent Care
05.2015 - 10.2016
Assisted in training new staff on medical terminology, proper procedures and regulations.
Facilitated daily administrative functions, including patient scheduling, and inventory management.
Coordinated physician's schedules and maintained patient flow.
Managed patient records using EMR software, in compliance of HIPAA.
Education
Bachelor of Science - Public Health
University of South Florida
Tampa, FL
08.2015
Skills
Quality Management Systems
Corrective Actions
Teamwork and Collaboration
Multitasking Abilities
Training Development
Planning and Coordination
Internal Audits
Documentation Review
Case Management
Research Policy
Timeline
Quality Control Analyst
Florida Department of Children and Families
03.2023 - Current
Eligibility Specialist II
Florida Department of Children and Families
04.2020 - 03.2023
Eligibility Specialist I
Florida Department of Children and Families
08.2018 - 04.2020
Clinical Data Abstractor (Temp)
Envision Physician Services
01.2018 - 08.2018
Lead Patient Care Coordinator
Holy Cross Hospital
10.2016 - 12.2017
Clinic Service Representative
Florida Orthopaedic Institute Urgent Care
05.2015 - 10.2016
Bachelor of Science - Public Health
University of South Florida
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