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Medicaid Auditor Resume

Jackson, MS

SUMMARY:

To gain employment that will allow me to utilize my diversified experience in administration, accounting, auditing, financial analysis, medical billing, budget analysis, or customer service.

SKILLS

Windows 98, XP and Vista

Microsoft Office

10 - key

Claims

Medicaid Management Information System

Optical Image Technology

Business Object Database

Reports On-Line

Patient Account Systems

EXPERIENCE:

Medicaid Auditor

Confidential, Jackson, MS

Responsibilities:

  • Provide report layouts to reveal financial audit findings and methods of analyzing financial data as well as maintain account receivables
  • Investigate providers and recipients of services under the Medicaid Program to determine compliance with State and Federal laws, rules, and regulations
  • Conduct in - depth investigations of all provider cases involving suspected fraud and/or abuse preliminary to an administration hearing or the initiation of a civil or criminal action
  • Acts as divisional liaison and consultant to agency administration and providers
  • Identify and eliminate fraud, waste, and abuse among Mississippi providers

Medicaid Auditor

Confidential, Jackson, MS

Responsibilities:

  • Handled claims issues accurately and efficiently on a daily basis
  • Communicated with providers involving check related requests such as electronic funds transfers, check copies, and missing checks
  • Classified overpayment files, processed checks and issued overpayment letters for collections
  • Answered all calls related to overpayments
  • Reviewed check receipts and entered data in the tracking system
  • Assisted in the development of charts and graphs for statistical analysis to accompany federal reports

Customer Service Specialist

Confidential, Jackson, MS

Responsibilities:

  • Coordinated and developed statistical reports for cost allocations
  • Analyzed outstanding account receivables for possible issues and resolved them
  • Assisted in hiring and training of staff
  • Created and managed donor records
  • Maintained filing system, scheduled appointments, ordered supplies, opened and distributed mail
  • Prepared purchase orders and requisitions

Front End Manager

Confidential, Jackson, MS

Responsibilities:

  • Maintained overall operational integrity of the store
  • Ensured all products and displays were merchandised effectively in order to maximize sales and profitability
  • Recruited and hired the most qualified candidates to meet the store’s needs
  • Forecasted scheduling needs to ensure sufficient associates on the floor to meet customer demands
  • Ensured customer concerns were solved effectively and promptly

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