Edlyn Viloria Email & Phone Number

Brooklyn, New York, United States

Brooklyn, NY

Manage the Entitlement (Medicaid) & Enrollment department for Alphacare's Managed Long Term Care Plan.

United States

o Conducts orientation and training with new staff on policies and procedures, criteria for the Revival Choice MLTC program, home and facility visit(s) for comprehensive health reassessment including, behavioral and home safety requirements on potential members, educate applicant, family and/or caregiver(s) on program benefits. o Ensure training materials.

Brooklyn, New York

Ensure completion and accuracy of new member enrollment information for timely submission of cases to enrollment broker.Coordinate, and track new referrals.Establish working relationships with referral sources.Maintain contact with referral sources to provide feedback on enrollment status, concerns, need for additional information, and assistance in.

New York NY

o Screen and explain the program to potential clients.o Receive, input, and verify insurance for new incoming referrals. o Assign all referrals to RNs and outsourced agencies for home assessments or to Medicaid Specialist if client has not Medicaid or RVI 3 Conversion.o Track all pending enrollments and follow up with New York Medicaid Choice –Maximus.o.

o Screen and explain the MLTC program to potential enrollees.o Receive, input, and verify Medicaid coverage for new referrals. o Submit Medical record to HRA for approval to MLTC program. o Track all enrollments and Disenrollment’s with New York Medicaid Choice/Maximus, HRA, DSS Westchester, Nassau and Suffolk County.o Provider Liaison for the Central.

-Process referrals and assign them to the Membership Development RN.-Submit enrollments, disenrollments, and conversions to HRA. -Verify patient's Medicaid eligibility and Medicare Part D Information.-Assist Membership Development Manager, Supervisors and RN's with medical record completeness. -Track referrals and update the vendor agencies, CHHA's and.

Registered new patients, scheduled appointments and recurring therapy sessions.Verified patients insurance, processed claims and medical codes into MediSoft.Maintained company info in MS Excel spreadsheets for owners.

Serviced three separate departments.Arranged meetings, travel arrangements, car services for employees.Maintained and updated phone list, attendance records, schedules, supplies.Met with prospective clients and vendors. Assisted management preparing and reviewing financial statements.

o Serviced three separate departments.o Arranged meetings, travel arrangements, car services for employees.o Maintained and updated phone list, attendance records, schedules, supplies.o Met with prospective clients and vendors. o Assisted management preparing and reviewing financial statements.

Answered all calls, assisted tenants, and maintained all clerical work.Assisted HR manager on daily tasks.Processed accounts payable, accounts receivables, and leases.