Medicaid Analyst Resume Samples

A Medicaid Analyst is employed by a healthcare facility or medical billing companies to monitor and optimize management processes. The job description and duties are listed on the Medicaid Analyst Resume as – leveraging costs, conducting research, making suggestions on how to allocate resources, improving patient care standards, and increasing staff productivity. Other accountabilities normally include – loading and maintaining records and files in document database; generating reports, participating in code reviews, and system testing; creating new processes to leverage data, and training new associates.

Those seeking to fulfill this type of role should denote on the resume qualifications such as – business acumen, analytical thinking, healthcare industry expertise, and strong communication skills. Knowledge of healthcare terminologies is a good plus. A degree in business administration and healthcare experience is a common thing seen on resumes.

 

Medicaid Analyst Resume example

Medicaid Analyst Resume

Headline : Service-focused worker with a strong commitment to serving the needs of disadvantaged youth and adults, including homeless, emancipated youth, and special-needs populations. Also interested in working with the elderly if possible I have a strong background with Medicaid and Medicare Savings Programs. Deeply committed to improving the quality of life for clients of various backgrounds, with a special interest in providing case management services for elderly and disadvantaged children.

Skills : Medical Billing, Medical Assisting, Help Desk.

Description :

    1. Conducted interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs.
    2. Made independent decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure.
    3. Interpreted and applies complex federal, state, and agency policies for each program.
    4. Conducted special investigations and compiles reports concerning fraud and location of absent parents.
    5. Counseled and refers potentially eligible recipients or applicants to other agencies.
    6. Contacted individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information.
    7. Developed reports using tools such as Tableau, Looker, SQL server, and Excel to automate and optimize processes and to track and assess performance.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
B.A. In Sociology


Medicaid Analyst Resume

Objective : To obtain a Medicaid Analyst position in the social services field that enhances social service skills. Addressing questions and complaints from Medicaid applicants and recipients, medical providers and the general public. Conducting periodic meetings to keep administrators aware of activities in service areas. Collaborating with agency personnel to ensure program coordination.

Skills : Microsoft Office, CJIS, Lotus Notes, Presentation, PC Troubleshooting, Research, Report Writing.

Description :

    1. Managed Medicaid application process for inmates.
    2. Maintained filing Word Excel system (confidential records).
    3. Compiled specs for Access contracts.
    4. Ran reports from PeopleSoft (NIS).
    5. Assisted in monitoring contract Compliance.
    6. Recorded findings, recommendations, and services provided.
    7. Skilled in building community support, key coalitions and strategic interagency partnerships.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
GED


Medicaid Analyst Resume

Objective : Medicaid Analyst is Under graduating and current graduate student looking to apply skills on a more professional level while acquiring any experience needed to further career, & Recruiting and selecting professional and support staff. Developing and maintaining working relationships with medical personnel and administrators, community leaders, and state and federal agencies to encourage the development of resources and integration of the agency with the surrounding community.

Skills : Knowledge of Arizona Health Care Cost Containment System, Planning.

Description :

    1. Conducted interviews with clients and makes other necessary collateral contacts for verification in determining initial or continuing eligibility or ineligibility for Medicaid Programs.
    2. Examined Application Center application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.
    3. Made decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure.
    4. Interpreted and applied complex federal, state, and agency policies for each program.
    5. Conducted special investigations and compiles reports concerning fraud and location of absent parents.
    6. Counselled and referred potentially eligible recipients or applicants to other agencies.
    7. Contacted individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
MS

Medicaid Analyst Resume

Summary : Growth oriented Medicaid Analyst professional with proven analytical, organizational and decision-making skills. Directs and coordinates the implementation of multiple Medicaid programs. Preparing annual budget request package based on analysis of office expenditures and projections of future operational needs. Securing and maintaining office(s), including all equipment and services necessary for office operations and the delivery of services to clients.

Skills : Microsoft Word, Typist And Oral And Written Communication.

Description :

    1. Recorded findings, recommendations, and services provided, completes case record forms and necessary correspondence in connection with assigned cases.
    2. Completes case record forms and necessary correspondence in connection with assigned cases.
    3. Followed updates for policies and procedure on Medicaid processing Uses multiple data systems to determine eligibility for Medicaid including Medicare, Child support, Temporary Assistance for Needy Families, Child Care Waivers, Supplementary Nutrition Assistance Program and Unemployment Databases.
    4. Conducted interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs.
    5. Examined application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.
    6. Made decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the rolldown procedure.
    7. Interpreted and applies complex federal, state, and agency policies for each program.
                  Years of Experience
                  Experience
                  7-10 Years
                  Experience Level
                  Level
                  Management
                  Education
                  Education
                  MS

                  Medicaid Analyst Resume

                  Objective : Experienced clerical Medicaid Analyst professional is pursuing an administrative support position. With proficiency in MS Office applications, other knowledge and skills include: Office Management Document Transcription Data Analyzing Team Building Specialized Scheduling Electronic File Keeping Reporting Grant Project Support Event Organizing Policy Development.

                  Skills : Banking, Excel, Microsoft Office 2010, Windows, Windows, Outlook, Power Point, Customer Service.

                  Description :

                    1. Processed Medicaid applications in English and Spanish for renewals.
                    2. Completed processing for child, pregnant, and disability Medicaid related cases.
                    3. Completed processing for Affordable Care Act applications.
                    4. Completed interview via phone and interoffice.
                    5. Community Outreached to inform the community about the services provided at Medicaid and Medicare.
                    6. Worked mandatory overtime when needed and voluntary overtime when needed.
                    7. Assisted new employees with acclimation to the information systems and case handling procedures and Health Information Portability and Accountability Act (HIPAA) procedures.
                  Years of Experience
                  Experience
                  0-2 Years
                  Experience Level
                  Level
                  Executive
                  Education
                  Education
                  Master's In Public Administration

                  Medicaid Analyst Resume

                  Summary : Primary objective is to obtain a challenging, career-progressive Medicaid Analyst position with a company where my years of customer relations, case management, networking, and communications abilities will have valuable application while upholding company's standard of excellence. Willing to relocate.

                  Skills : Microsoft Office With Emphasis On Excel And Word, Programming.

                  Description :

                    1. Made initial and continuing determination as to clients eligibility for all Medicaid programs.
                    2. Conducted interviews with clients and make other necessary collateral contacts for verification in determining initial or continuing eligibility or ineligibility for Medicaid Programs.
                    3. Examined Application Center application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.
                    4. Made decisions on complex eligibility factors and determine level of benefits for federal and state funded programs as a result of the roll down procedure.
                    5. Interpreted and applied complex federal, state, and agency policies for each program.
                    6. Conducted special investigations and compile reports concerning fraud and location of absent parents.
                    7. Counselled and referred potentially eligible recipients or applicants to other agencies.
                  Years of Experience
                  Experience
                  7-10 Years
                  Experience Level
                  Level
                  Management
                  Education
                  Education
                  MHA In Master's

                  Medicaid Analyst Resume

                  Objective : To obtain employment in social services, psychological research, evaluation or counseling professions.& Counselling and referring potentially eligible recipients or applicants to other agencies. Contacting individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information. Recording findings, recommendations, and services provided; completes case record forms and necessary correspondence in connection with assigned cases.

                  Skills : Microsoft Office, Excel, Outlook, Keyboard.

                  Description :

                    1. Conducted interviews with clients and makes other necessary collateral contacts for verification in determining initial or continuing eligibility or ineligibility for Medicaid Programs.
                    2. Examined Application Center application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.
                    3. Made decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure.
                    4. Interpreted and applied complex federal, state, and agency policies for each program.
                    5. Conducted special investigations and compiles reports concerning fraud and location of absent parents.
                    6. Counselled and referred potentially eligible recipients or applicants to other agencies.
                    7. Contacted individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information.
                  Years of Experience
                  Experience
                  0-2 Years
                  Experience Level
                  Level
                  Entry Level
                  Education
                  Education
                  BA In Psychology

                  Medicaid Analyst Resume

                  Summary : Highly qualified Medicaid Analyst with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself. Conducting special investigations and compiles reports concerning fraud and location of absent parents.

                  Skills : Excellent Verbal And Written Communication, Leadership, Customer And Co-worker Relations.

                  Description :

                    1. Made independent complex decisions on clients' Long Term Care/Home Community Based Services Waiver and/or Disability-Related eligibility factors.
                    2. Interpreted applicable state and federal program policies Completed special investigations and summaries of evidence for presentation to an Administrative Law Judge for review.
                    3. Managed a staff of 5-8 people in the absence of the Medicaid Analyst Supervisor.
                    4. Developed Rapid Response Medicaid Enrollment Model to assist clients affected by disasters or mass lay-offs Accurately prepared monthly statistical reports.
                    5. Completed various forms for case record documentation and notification of eligibiltiy decision.
                    6. Represented agency at special events.
                    7. Served as New Orleans Regional Long Term Care Liaison.
                  Years of Experience
                  Experience
                  7-10 Years
                  Experience Level
                  Level
                  Management
                  Education
                  Education
                  BA In Psychology

                  Medicaid Analyst Resume

                  Headline : Skilled and experienced Insurance Plan Auditor with extensive background in benefits management. Expertise and in-depth knowledge in fraud abuse auditing. Extensive working knowledge of government rules and regulations research and implementation. Working knowledge of General Accounting processes and procedures.

                  Skills : Customer Service Representative, Insurance Plan.

                  Description :

                    1. Recorded findings, recommendations, and services provided, completes case record forms and necessary correspondence in connection with assigned cases.
                    2. Record findings, recommendations, and services provided.
                    3. Completed case record forms and necessary correspondence in connection with assigned cases.
                    4. Established collaborative efforts with 22 nursing facilities, 66 Group Homes and 5 Support Coordinators.
                    5. Recorded findings, recommendations, and services provided, completes case record forms and necessary correspondence in connection with assigned cases.
                    6. Contacted individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information.
                    7. Recorded findings, recommendations, and services provided, completes case record forms and necessary correspondence in connection with assigned cases.
                  Years of Experience
                  Experience
                  5-7 Years
                  Experience Level
                  Level
                  Executive
                  Education
                  Education
                  Bachelor Of Arts In English

                  Medicaid Analyst Resume

                  Objective : To offer my recently completed formal education, loyalty, dependability, military work ethic and wide breadth of essential and related work experiences in exchange for an opportunity for an internship, or entry to mid-level position in a related medical administrative field with a company that both advocates and stimulates an atmosphere for personal growth and further advancement.

                  Skills : Microsoft Office, 10-Key, Military Assistant.

                  Description :

                    1. Conducted interviews with clients and makes other necessary collateral contacts for verification in determining initial or continuing eligibility or ineligibility for Medicaid Programs.
                    2. Examined Application Center application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.
                    3. Made decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure.
                    4. Interpreted and applied complex federal, state, and agency policies for each program.
                    5. Conducted special investigations and compiles reports concerning fraud and location of absent parents.
                    6. Advised and referred potentially eligible recipients or applicants to other agencies.
                    7. Contacted individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information.
                  Years of Experience
                  Experience
                  0-2 Years
                  Experience Level
                  Level
                  Executive
                  Education
                  Education
                  Bachelor Of Arts In English