At VillageCareMAX, I reconcile membership data with external State and CMS databases to resolve eligibility discrepancies and maintain an accurate enrollment census.
I conduct quality assurance audits on enrollment files and Medicare applications, and I verify member correspondence for accuracy and regulatory compliance.
I also coordinate with external BPaaS vendors to troubleshoot system issues, eligibility errors, and processing delays. At Affinity Health Plan, I supported provider network accuracy and operational reporting through provider data verification, quality checks, and delegated entity roster workflows.
