Stacy S. Schmitz
Broadview Heights,OH
Summary
Dynamic Claims Technical Expert at the Social Security Administration with a proven track record in claims adjudication and policy interpretation. Renowned for resolving complex entitlement challenges and enhancing operational efficiency. A skilled communicator and trainer, adept at fostering team development and delivering impactful training.
Successfully increased the revenue dramatically of a social service agency through direct marketing to families of people with disabilities that required in-home care.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Claims Technical Expert
Social Security Administration
Akron, Ohio
10.2011 - Current
- Extensive understanding of the Social Security Act titles, Internal Revenue Code, and relevant public laws and regulations impacting social insurance programs.
- Responsible to assist staff with their most technical questions and challenging claimants in a real time high volume office.
- Proficient in creating and preserving detailed audit trails for claimant documentation while safeguarding highly sensitive federal and IRS data.
- Explained provisions of federal social insurance laws to individuals with diverse language skills, and/or disabilities during sometimes stressful public encounters.
- Expertly utilized agency's integrated automated case processing systems and over 150 different federal computer programs.
- Responsible for assisting people in establishing federal entitlement and receiving benefits, adjudicating, authorizing, or reconsidering claims for benefits, and representing federal social programs before the general public.
- Conducted and held various intensive training classes for new hires and seasoned staff that were advancing to claims specialist positions.
- Assessed operational issues using reports, quality reviews, and appraisal programs to identify root causes of staff performance and reported said findings in detailed reports to federal district managers and the area director's office.
- Granted exclusive top federal access and have advanced skills with the Lexus Nexis applications.
- Studied hundreds of pages of policy weekly and disseminated that information to up to 5 offices at a time by way of workflows I created, charts I made and tools and information that staff needed to do their jobs during fast paced policy updates and challenging staff shortages.
- Was selected as the office cashier- I had authority to write federal checks to the public in situations of dire need/ emergencies.
- Created and maintained a one note with hundreds of workflows that I shared with other offices.
- Considered a top Medicare expert at SSA with staff calling me from as far away as California and Florida due to my reputation to fix any entitlement challenge.
Claim Specialist
Social Security Administration, SSA
Akron, OH
09.2003 - 09.2011
- Responsible for assisting individuals in establishing their eligibility for Social Security benefits by conducting interviews, gathering information, analyzing claims, and making decisions regarding entitlement to benefits.
- Interviewed the public either in person or over the phone; this role involves verifying information, resolving discrepancies, and utilizing SSA computer systems to update claim details.
- Meeting with individuals to gather information regarding their potential eligibility for Social Security benefits, including medical records, employment history, and personal details.
- Reviewing submitted documentation and assessing whether an individual meets the criteria for specific Social Security programs including retirement, disability, or survivor benefits.
- Determining whether to approve or deny a claim based on established policy guidelines and federal laws and regulations.
- Checking the accuracy of data provided by applicants through various sources including medical records, employer reports, and government database.
- Clearly communicating the details of a claim decision to the applicant, including the reasons for approval or denial.
- Addressing concerns and questions from applicants regarding their claim status, including handling appeals up to and including Administrative Law Judges.
- Accurately documenting all aspects of a claim within the SSA computer system.
Program Manager
Anthony Wayne Services
Cleveland, Ohio
11.2002 - 09.2004
- Spearheaded the overall administration of the North East Ohio Supported Living Programs.
- Managed funding from OD/DD, Ohio Medicaid Waiver, and private donors for supported living services
- Oversaw administration of North East Ohio Supported Living Program.
- Provided individual job coaching at various public work sites to individuals with disabilities.
- Interviewed and hired top candidates, authorizing background checks and drug testing for qualified applicants..
- Educated employees on effective methods for assisting those with disabilities.
- Delivered comprehensive staff training covering areas such as OSHA, health and safety, diversity awareness, and HIPAA compliance.
- Facilitated extensive sessions addressing major unusual incident reporting, developmental disabilities paradigms, ethics in documentation practices, personnel policies.
- Managed employee schedules for multiple residences and monitored performance.
- Provided 24/7 support through on-call cell phone and pager, conducted daily site visits, audited services, and ensured documentation compliance
- Acted as a liaison among staff, families supported and Cuyahoga and Summit County Boards of MR/DD.
- Conducted quick assessments and coordinated emergency services or psychiatric hospitalizations to stabilize conditions.
- Managed crisis situations, especially involving individuals with severe behavioral issues.
- Led performance reviews and recommended salary increases for promotion-eligible team members.
- Evaluated employees annually on a detailed 5-point performance scale across 40 areas
- Created employee corrective action plans, monitored progress, and provided feedback.
- Terminated employees for serious policy and client health and safety infractions.
- Sought new business opportunities by actively engaging with more families.
- Increased revenue significantly through successful marketing strategies.
- Generated substantial business growth by increasing focus on new marketing strategies.
- Quadrupled monthly gross revenue within first year.
- Collaborated on managing the program cost center using Citrix software.
- Produced Excel spreadsheets that tracked and organized all program areas.
- Reviewed monthly purchase and staffing costs for accuracy.
- Corrected financial mistakes and reported to supervisors in Ft Wayne, Indiana.
- Participated in multi-day training sessions focused on staffing recruitment, employee management, marketing strategies, client rights regulations, behavioral interventions updates and financial software best practices.
- Engaged in professional development to stay current with industry standards and practices.
Education
Master of Arts - Social Work Administration
The Ohio State University
Columbus, OH06-2002
Bachelor of Arts - Social Work
University of Akron
Akron, OH06-2000
Skills
- Social Security & Medicare regulations
- Policy interpretation
- Claims adjudication
- Data analysis
- Project management
- Regulatory compliance
- Staff training & mentoring
- Effective communication
- Problem solving
- Quality assurance
- Public speaking
- Business intelligence
- Technical writing
- Error detection
- Incident management
- Attention to detail
- Resolve complex technical problems
- Multitasking and prioritization
- Federal & state background check compliant
Certification
- 2010 Commissioner Award Recipient. Highest Federal Civilian Honor.
- Received dozens of yearly cash incentives and bonuses for exceeding job goals every single year since hired.
Timeline
Claims Technical Expert
Social Security Administration
10.2011 - Current
Claim Specialist
Social Security Administration, SSA
09.2003 - 09.2011
Program Manager
Anthony Wayne Services
11.2002 - 09.2004
Master of Arts - Social Work Administration
The Ohio State University
Bachelor of Arts - Social Work
University of Akron
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