Renee Scarborough
Willingboro
Summary
Results-driven Field Service Supervisor with extensive experience at the Division of Medical Assistance and Health Services. Expert in regulatory compliance and quality control, successfully leading a team to enhance case evaluation processes. Proven analytical skills and a commitment to staff development, ensuring adherence to state and federal guidelines while improving operational efficiency.
Overview
13
13
years of professional experience
Work History
Field Service Supervisor 3, Quality Control Reviewer
Division of Medical Assistance and Health Services
Hamilton
06.2024 - Current
- Company Overview: Bureau of Quality Control
- Approves case findings for a staff of four, ensuring that deficiencies were correctly identified according to state and federal regulations when reviewing Medicaid and CHIP cases completed by the Eligibility Determining Agencies
- Complete performance evaluations for each case and offers feedback for improvement to employees
- Manages the case load and production of staff to meet the Bureau of Quality Control's unit goals
- Consults with other state contacts to ensure state and federal regulations are being properly communicated to Eligibility Determining Agencies when patterns of problems are recognized
- Responsible for the timesheets and annual performance reviews of staff
- Train staff on Policy and Procedure updates
- Bureau of Quality Control
Program Support Specialist 1 Assistance Programs, Quality Control Reviewer
Division of Medical Assistance and Health Services
Hamilton
03.2018 - 05.2024
- Company Overview: Bureau of Quality Control
- Reviewed and perform Medicaid case reviews from the 21 Eligibility Determining Agencies along with Conduent the state of NJ vendor provider for accuracy and completeness
- Analyzed case files to assess eligibility errors and to ascertain that the Eligibility Determining Agencies are abiding by program guidelines and NJ Family Care Standards
- Evaluated case records to ensure services are being rendered in accordance with State and Federal guidelines
- Analyzed and determined client eligibility from electronic verification obtained from multiple agency systems to include but not limited SOLQ, DOVE, MES, NJMMIS and Clear along with documents supplied by the county and vendor offices
- Devised and prepared clear and accurate reports containing comprehensive findings and conclusions
- Cooperatively work with other staff members during team assignments
- Current Team Lead and on boarding trainer
- Bureau of Quality Control
Human Services Specialist 2
Burlington County Board of Social Services
Mount Holly
11.2011 - 03.2018
- Reviewed, analyzed and processed New Jersey Family Care and Affordable Care Intake and Redetermination applications
- Performed New Jersey Family Care and Affordable Care special projects using the Shared Data Warehouse listing provided to the agency
- Reviewed information on forms, applications, and other financial assistance documents for completeness and accuracy during eligibility process
- Interviewed customers to verify and determine program eligibility
- Completed the necessary forms for applicants' program eligibility
- Identified possible financial resources for applicants when appropriate; providing applicants with information to seek benefits from other agencies such as the Social Security Administration, Veterans Administration, and State Employment Services
- Provided information to families or individuals to achieve self-sufficiency
- Advised supervisor of customer complaints and responded as instructed
- Collected, reviewed and recorded data to evaluate the customer's need for support services
- Provided information for the preparation of case summaries for hearings; attended hearings when required
- Conveyed information to the general public; informs customer of available public assistance and other related programs
- Consulted with the supervisor to discuss issue relating to customer eligibility
- Prepared reports and maintains records and files
- Utilized various types of electronic and/or manual recording and information systems used by the agency, office or related units
Acting Assistant Supervisor
Burlington County Board of Social Services
Mount Holly
05.2017 - 10.2017
- Performed reviews, analysis and evaluation of cases by HSS I and HSS II's to determine client's eligibility for program services and or the validity of decision made regarding program assistance
- Evaluated new, current and former applications which included Snap, General Assistance, TANF and New Jersey Family Care for completeness and accuracy to ensure internal quality control and that the proper procedures and appropriate regulations have been followed by staff and reported any errors to supervisors and administrators
- Handled difficult cases requiring research for Snap, General Assistance, TANF and New Jersey Family Care
- As a lead worker, instructed employees in lower level positions specific job task techniques
- As a lead worker, answered questions and provided guidance to employees in lower level positions as to procedures, policies and Federal regulations for SNAP, General Assistance, TANF and New Jersey Family Care programs
- Supervised a staff of 20 employees in lower level positions
- Advised clients on agency guidelines pertaining to their financial resources for eligibility program services
- Attended various meetings such as; investment clubs, real estate investment clubs, etc., to create new business
- Set goals and objectives to meet monthly production goals
- Responsible for expediting loan processing, underwriting and closing
- Made sure all customers received excellent service through and after closing
- Consistently had one of the highest loan pipelines and number of closed loans
- Conducted in depth client interviews by telephone to determine and confirm accuracy of client applications
- Reviewed and analyzed documentation from clients to verify legitimacy and authenticity
- Responsible for following up with previous Gelt customers to prospect for additional business through telephone sales on a daily basis for at least 4 hours
- Adept in understanding people's financial needs in order to provide financial and credit consultation to assess their short or long term financial goals
- Utilized computer analysis to develop investment plans, i.e
- College funds, and retirement planning
- Consistently placed at the top of my peer group within the region according to the bank's system of internal performance rating
Education
B.A. - Economics
Rutgers University
New Brunswick, NJ01.1990
Skills
- Program Management
- Regulatory Compliance
- Case Evaluation
- Quality Control & Performance Evaluation
- Training & Staff Development
- Analytical & Reporting Skills
Timeline
Field Service Supervisor 3, Quality Control Reviewer
Division of Medical Assistance and Health Services
06.2024 - Current
Program Support Specialist 1 Assistance Programs, Quality Control Reviewer
Division of Medical Assistance and Health Services
03.2018 - 05.2024
Acting Assistant Supervisor
Burlington County Board of Social Services
05.2017 - 10.2017
Human Services Specialist 2
Burlington County Board of Social Services
11.2011 - 03.2018
B.A. - Economics
Rutgers University
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