Provet Palmer
Matthews,NC
Summary
Healthcare eligibility and documentation specialist with extensive experience in social services and insurance verification. Proven track record in regulatory compliance and accuracy while managing high-volume caseloads. Expertise in ensuring timely eligibility determinations and delivering exceptional customer service.
Overview
26
26
years of professional experience
Work History
Eligibility Specialist I
Mecklenburg County
Charlotte, USA
06.2025 - Current
- Screen and verify patient and client documentation for Medicaid eligibility, ensuring accuracy and compliance with county and state policy.
- Facilitated timely eligibility determinations by assisting clients in securing required verifications and ensuring documentation met privacy and organizational standards.
- Collaborated with providers to resolve documentation gaps while maintaining detailed audit-ready records and updating case information for compliance and accuracy.
- Identified clients needing screening from daily logs and maintained up-to-date records to support efficient case management.
State Eligibility Consultant
State of Indiana
01.2014 - 06.2025
- Assessed eligibility for public assistance programs including TANF, SNAP, and Medicaid to ensure compliance with state regulations.
- Facilitated interactive interviews and validated client information, ensuring accurate and timely case determinations.
- Resolved complex case issues and coordinated with contractors for prompt processing of specialized files.
- Prioritized high volume workloads while meeting strict state and federal guidelines.
- Provided consistent, courteous customer service to diverse populations, enhancing client satisfaction.
Eligibility Resource Advocate
Wishard Health
01.2009 - 01.2014
- Interviewed and screened patients for medical insurance payer programs, secured verifications from companies and agencies, and reviewed daily admission census and sign-in logs to identify patients for screening, facilitating access to necessary healthcare services.
- Recorded and updated patient information in STAR and IndeApp systems, ensuring accuracy for effective tracking.
- Advised clients on legal rights and obligations in healthcare matters, empowering them to navigate complex healthcare systems effectively.
- Drafted and reviewed contracts, agreements, and legal documents for compliance, ensuring adherence to regulatory standards and safeguarding organizational interests.
- Represented the organization in hearings and negotiations with regulatory bodies.
Credentialing Specialist/Sr. Front Office Assistant
St. Vincent Seton Specialty Hospital/Physician Network
05.2007 - 01.2009
- Coordinated administrative support for executive director, quality and compliance team, and risk management team while verifying medical staff credentials to ensure compliance.
- Verified provider credentials for compliance with hospital standards.
- Managed application processes for medical staff and privileges, facilitating timely onboarding and adherence to hospital standards.
- Coordinated with healthcare professionals to gather documentation, streamlining credential verification process.
- Greeted patients, managed check-in/out processes, answered phones, scheduled appointments, collected and balanced co-pays and deductibles, verified insurance, and maintained filing system.
Patient Care Secretary
Odyssey Healthcare
04.2006 - 03.2007
- Prepared patient medical information and coordinated staffing schedules for CNAs, nurses, and MAs, facilitating seamless patient care delivery.
- Maintained comprehensive records and documentation for patient files, ensuring legal and medical documents were up-to-date and signed by medical staff and physicians for regulatory compliance.
- Ordered durable medical equipment and managed accurate inventory records to meet patient needs efficiently.
Medical Records Receptionist
Urology of Indiana
02.2004 - 04.2006
- Reviewed and updated patient charts to ensure all relevant medical history was accurate and accessible for physician appointments.
- Coordinated retrieval of patient charts from various locations via email, fax, and telecommunications, ensuring availability of accurate records for physician use.
- Facilitated timely transfer of patient records to external offices and facilities, enhancing continuity of care for patients.
- Organized patient charts and medical records to ensure accessibility and compliance within office locations.
- Prepared medical information prior to patient office visits for four Doctors, two Physician assistants, and labs for each daily schedule.
- Printed and distributed lab results, x-rays, and surgical reports to relevant medical staff.
- Extracted and transcribed dictation from physicians' Dictaphones, organizing the resulting documents for efficient mail distribution within the office.
Health Unit Coordinator (Unit Secretary)
Battle Creek Health Systems
01.2000 - 08.2003
- Transcribes physician’s orders to unit records and files (e.g. medication records, kardexes, etc.).
- Maintains the patient medication records and kardex system.
- Processes orders for x-ray, lab and other diagnostic and therapeutic areas.
- Prepares procedure/surgical checklists and consent forms.
- Assembles chart materials for newly admitted patients.
- Processes charts at discharge, forwards discharge charts to medical records.
- Assisted nursing staff by providing essential resources and support to enhance unit operations.
- Executed clerical duties to compile, transcribe, prepare, and maintain patient records on a specific nursing unit.
- Served as communication liaison for nursing unit, facilitating information flow among staff and visitors.
- Communicates with and assists physicians/physicians’ offices.
- Ensured confidentiality of patient and staff information.
- Trained and mentored new employees on unit protocols and procedures, ensuring adherence to quality care standards.
Education
Certificate of Completion -
Kellogg Community College Business Career Academy
Battle Creek, MI01-2000
Diploma - General Studies
Battle Creek Central High School
Battle Creek, MI01-1993
Skills
- Eligibility Assessment
- Public assistance eligibility
- Insurance Verification
- Medicaid compliance
- Case Management
- Care coordination
- Patient service
- Patient interaction
- Patient registration
- Medical scheduling
- Data management
- Data entry
- Records management
- Conflict resolution
- Records administration
- EMR systems
- Eligibility Software
- Client Management System
- Medical office experience
- Customer service excellence
- Clerical support
- Administrative support
- Front desk operations
- Patient check-in and check-out
- Attention to detail
- Time management
- Multitasking
- Conflict resolution
- Phone Etiquette
- Organizational skills
- Communication skills
- Microsoft Office Suite
- Microsoft Excel
- Microsoft Word
- Office software
- Documentation accuracy
- Client assessment
- Caseload Prioritization
- Health insurance knowledge
- HIPAA guidelines
- Administering interviews
- Appointment setting
- Credentialing processes
- Front desk operations
References
Available upon request
Languages
English
Timeline
Eligibility Specialist I
Mecklenburg County
06.2025 - Current
State Eligibility Consultant
State of Indiana
01.2014 - 06.2025
Eligibility Resource Advocate
Wishard Health
01.2009 - 01.2014
Credentialing Specialist/Sr. Front Office Assistant
St. Vincent Seton Specialty Hospital/Physician Network
05.2007 - 01.2009
Patient Care Secretary
Odyssey Healthcare
04.2006 - 03.2007
Medical Records Receptionist
Urology of Indiana
02.2004 - 04.2006
Health Unit Coordinator (Unit Secretary)
Battle Creek Health Systems
01.2000 - 08.2003
Certificate of Completion -
Kellogg Community College Business Career Academy
Diploma - General Studies
Battle Creek Central High School