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Executive Office Of Health And Human Services - Benefit Eligibility Referral Social Worker Resume Example

Liam Johnson
XX XXXXXXXXX XXXXXX, Boston, MA 02125
Ph: XXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXX
Professional Summary

Service-oriented Outreach & Operations Advisor with nine years background in Human services. Core competencies include Knowledge of Masshealth programs, Virtual Gateway system and Lead CAC Trainer as well as excellent communication and time management skills. Handles tasks with accuracy and efficiency.

Skills
  • Bilingual (Portuguese, Capeverdean Creole)
  • Active Listening
  • Time Management
  • Computer Skills Microsoft Office (Word, Excel, Access, PowerPoint), Microsoft Outlook, Internet, SDK, NEHAN, Cheetah, Meditech, Virtual Gateway, MAPS
  • Administration and Management
  • Coordination
  • Critical Thinking
  • Judgment and Decision Making
  • Social Perceptiveness
  • Education and Training
Experience
BENEFIT ELIGIBILITY REFERRAL SOCIAL WORKER Nov 2015Present Executive Office of Health and Human Services Charlestown , MA
OUTREACH & OPERATIONS ADVISOR Jan 2014Nov 2015 HealthCare Financial Inc Boston, MA
  • Serves as Knowledge expert for the Patient Enrollment specialist staff; to share expertise with goal of elevating the knowledge base and increasing productivity.
  • Conducts front end analysis and quality control processes by developing, modifying and executing queries and reports that reflect trend, work completed, pending or not touched.
  • Assist in the development, review and documentation of the front-end processes in collaboration with other management staff.
  • Manages referral process; PES deployment
  • Responsible for the on boarding and training of newly hired PES and/or existing team members (aware of and comply with company and government policies, procedures and regulations)
  • Serves as general point of contact for clients in collaboration with Ops Manager, accountable for providing status update and escalating client concerns.
  • Provide service for the elderly population, completing the FEW (Frail Elderly Waiver) and LTC (Long Term Care) application.
  • Educated patient and family members on various medical outreach programs and the importance of utilizing the programs.
  • Interview patients to determine eligibility for health coverage assistance programs based upon review of family size, financial history, availability of other health insurance, and review of assets as needed. Respond to inquiries and delegate specific requests to appropriate staff.
  • Lead CAC Trainer (Certification Application Counselor)
  • Represents the company while attending the Mass Health Technical Forum (MTF) meetings.
SR. PATIENT ENROLLMENT SPECIALIST Jan 2013Jan 2014 Healthcare Financial Inc Boston, MA
  • Conducts QC processes by developing, modifying and executing queries and reports that reflect work completed, pending or not touched.
  • Participates in training new hires or existing team members; ensures all new hires are aware of and comply with company and government policies, procedures, and regulations.
  • Accountable for providing feedback during cross training opportunities to enhance the department's functionality, roles and training materials.
  • Works with CM Representatives on escalated cases to ensure appropriate measures are taken to get cases resolved.
  • Serves as knowledge expert for PES staff; to share expertise and experience with the goal of elevating the knowledge base and increasing productivity.
  • Participates in department and/or HFI pilot projects as assigned by the MA Team Leader/On site Supervisor.
  • Assists in the development, review and documentation of new processes in collaboration with other management staff.
  • Assists colleagues on special tasks and projects as needed.
  • Provides back fill support in daily operations as needed.
  • Serves as a hospital client point of contact. Accountable for providing status updates and escalating client concerns, trends, roadblocks, and conflicts to upper management.
PATIENT ENROLLMENT SPECIALIST Jan 2011Jan 2013 Healthcare Financial Inc Boston, MA
  • Educated patient and family members on various medical outreach programs and the importance of utilizing the programs.
  • Distributed educational materials on HFI and government programs.
  • Identified appropriate programs for patients and facilitates enrollment into state Medicaid/MassHealth entitlement programs.
  • Screened patients in hospitals, clinics, health centers, and/or patient's home. Also, performs telephone screening of patients to determine eligibility for Medicaid/MassHealth entitlement programs.
  • Completed necessary forms within the time line established. Documents cases including assessment and patient's consent to obtain assistance and release forms.
  • Managed referrals in accordance with company guidelines.
  • Traveled to hospitals and other client sites throughout the day as assigned. On occasion, may visit patient's homes to determine patient and family needs for follow-up on application process.
  • Advocated on a case, policy and program level by understanding individual needs.
  • Demonstrated receptive, emphatic and sensitive attitudes by understanding and valuing cultural diversity.
  • Provided linkage with appropriate community and government resources by maintaining knowledge of other systems, making referrals and identifying other unmet needs.
  • Represented the company while visiting our clients on assigned schedules; including hospitals, patient's home and the community.
PATIENT FINANCIAL COUNSELOR Jan 2006Jan 2011 Boston Medical Center Boston, MA
  • Protected patient and family confidentiality.
  • Interviewed patients to determine eligibility for health coverage assistance programs based upon review of family size, financial history, availability of other health insurance, and review of assets as needed. Respond to inquiries and delegate specific requests to appropriate staff.
  • Assisted patients identified as having no or incomplete health insurance coverage to inform and educate about available resources and coverage programs/plans.
  • Submitted written reports of work activity when requested; complete daily, weekly and/or monthly statistics to document volume of patients enrolled/ineligible.
  • Outreached to patients who need guidance in obtaining health insurance, food stamps and other assistance.
  • Responsible for ensuring collection of assigned patient accounts with the goal of providing patient-focused customer service and achieving the departmental goal of ensuring maximum revenue and cash flow benefit to the hospital
Education
Bachelor of Science : Human Services Springfield College School of Human Services Charlestown , MA
Certifications
  •  Lead CAC Trainer (Certification Application Counselor)  2012, 2013, 2014, 2015, 2016
  •  HHA Home Health Aid  (1997)
  •  CNA Nursing Assistant (1997)
Community Service

American Red Cross 2015

Pine St. Inn 2012

Rosie's Place 2011

Language
Portuguese, Capeverdean Creole
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Resume Details

This is a real resume for a BENEFIT ELIGIBILITY REFERRAL SOCIAL WORKER in Boston, Massachusetts with experience working for such companies as Executive Office Of Health And Human Services, Healthcare Financial Inc, Healthcare Financial Inc. This is one of the hundreds of BENEFIT ELIGIBILITY REFERRAL SOCIAL WORKER resumes available on our site for free. Use these resumes as templates to get help creating the best BENEFIT ELIGIBILITY REFERRAL SOCIAL WORKER resume.

Previous Companies:

  • Executive Office of Health and Human Services
  • HealthCare Financial Inc

Previous Job Positions:

  • BENEFIT ELIGIBILITY REFERRAL SOCIAL WORKER
  • OUTREACH & OPERATIONS ADVISOR
  • SR PATIENT ENROLLMENT SPECIALIST
  • PATIENT ENROLLMENT SPECIALIST
  • PATIENT FINANCIAL COUNSELOR

Schools:

  • Springfield College School of Human Services

Level of Education:

  • Bachelor of Science

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