Joseph V Sellitto Email & Phone Number

Greater New York City Area

Brooklyn, New York

Greater New York City Area

Health Plus PHSP was acquired by Amerigroup Corporation effective 5/2012. In addition to my responsibilities listed with Health Plus PHSP:- Assisted in Quarterly Compliance Training.- Conducted HIPAA walk-through, reported results and recommendations for Corrective Action Plans.- Monitored External/Internal Audit Secret Shopper and Internal Audit review and investigation results.- Assisted in the routing and monitoring of information retrieved via Compliance and Ombudsman hotlines.

Greater New York City Area

(Swiss Post Solutions Contracted Client Service Manager @ Health Plus PHSP account.)Project Manager:- Developed, implemented and managed a division of the Special Investigation Unit as per review and interpretation of new regulations and contract requirements in Facilitated Enrollment Integrity in a 6 week time frame.- Developed policy, processes, procedures and internal forms including a 100+ page comprehensive department manual.- Oversaw verification of Medicaid, Child Health Plus and Family Health Plus member applications for fraud, waste or abuse.Manager/Internal Auditor:- Developed and conducted Internal Audits.- Oversaw Field Observation Audits of Medicaid Outreach Representatives and Medicare Sales Representatives.- Performed internal reviews of various departmental risk areas including Medical Management (Health Services & Behavioral Health) Medicare/Medicaid UM & Grievances and Appeals, Medicaid New Hire Training Program, Medicare Sales' Representatives Insurance License Validity, Claims Department Prompt Payment process and Interest calculations.- Conducted reviews to verify policies and procedures were interpreted and applied properly and carried out as intended. Where changes in operating conditions/regulations have made policies & procedures obsolete or inadequate; recommend Corrective Action.- Prepared written reports and recommendations/Corrective Action Plans at the conclusion of each audit identifying deficiencies,compliance and/or noncompliance.- Proficient in Medicaid & Medicare Eligibility & Regulatory Requirements.- Proficient in Medicaid & Medicare Processes & Procedures.- HIPAA & HITECH compliance.

Greater New York City Area

- Analyzed data compiled from various sources (Facets, ePaces, Internal database etc.)- Utilized advanced Excel formulas (Pivot Tables, VLOOKUP) to manipulate data according to required results based on information needed for investigation/review.- Created Analysis Summary Reports for submission to Management for review.

Greater New York City Area

- Managed Offshore Outsourcing contracts for Senior Managing Director. Negotiated renewals via Legal Department.

Greater New York City Area

- Assisted Managing Director with all aspects pertaining to Closed-end Funds.

Greater New York City Area

- Prepared work papers needed for submission to Regulatory agencies.

- Assisted in the management of daily projects for CIO.

Greater New York City Area

- Assisted in the Management of a team of 15 + Fund Accountants on 2 year Project preparing for relocation to Dallas, Texas.

Brooklyn, New York

- Managed Financial/Regulatory Department.- General Ledger and Trial Balance.- Depreciation of Fixed Assets.- Accruals and Prepaid Accounts.- Quarterly and Annual Budgets.- Regulatory Reporting to FHLB and OTS.- GAAP to RAP accounting.- Securities accounting.- Payroll- Accounts Payable & Receivable.- Liaison to External Auditors.- Managed 6 FTEs.- Reported to Chief Financial Officer/SVP.

Brooklyn Heights

- Managed 8 FTEs (6 Tellers, 1 Head Teller and 1 Customer Service Representative.)- Managed accounts totaling approximately $156 million in assets.