Maxwell C. Email & Phone Number

United States

Tampa, Florida, United States

Tampa, Florida, United States

• Provided resolution for complex member scenarios and utilized call measures to reduce, prevent, and mitigate call escalations while providing high level member satisfaction.
• Managed and executed complex decision making to ensure risk mitigation for high-risk transactions by effectively employing critical thinking and communication on each call.
• Exercised MRT empowerments in specific situational resolutions per Knowledge Central (KC) guidance.
• Proficient in complaint tracking through detailed explanations of scenarios and final resolutions.
• Aided and supported frontline MSR help inquiries and provided detailed guidance for call control and education through resources as a subject matter expert.
• Dual skilled servicing for both deposit and credit card escalations as well as helpline inquiries.

Tampa, Florida, United States

• Provided operational support to members and their complex banking needs with an emphasis on deposit and high risk domestic/international wire skillsets. Handled upwards of 40 calls per day.
• Actively evaluated and completed in-depth reviews on accounts for fraud mitigation through measured and monitored controls.
• Adhered to written risks and compliance regulations by utilizing KC on every call.
• Successfully protected members financial security by adhering and implementing full SERVE components with each call. Employed empathy, active listening, and call control with each interaction.
• Expanded USAA core values by being the Team Lead and Point of Contact for all technical and compliance matters.
• Contributed to the growth and development of USAA and peers by being actively engaged through Y-Cord sessions with new hires and frequently provided KC recommendations for refinement and adaptation.

Largo, Florida, United States

• Independently monitored all initial and recertification certificates of medical necessity for oxygen rental equipment for Medicare recipients.
• Provided and obtained over 30 certificates of medical necessity daily.
• Indexed and filed all certificates for Medicare audit reviews for over 2500 active rentals.
• Arranged and coordinated patients to be seen by their doctors and obtain updated oxygen titration SATS.
• Ensures active benefit coverage for all rentals and assisted with pickup and delivery coordination and documentation.

• Conducted and monitored over 800 quality assurance audits and account reviews a month to identify trend patterns and deficiencies through testing and evaluations as it related to Medicaid eligibility.
• Performed quarterly onsite facility audits that identified opportunistic frailties and provided solutions as well as educational assistance through coaching, training, and production of standardized processes.
• Provided recommendations to leadership and collaborated to develop new Medicaid eligibility national standards for growth driven results.
• Reported and presented high level accuracy trend data from audit findings. Offered data and solutions to area management for 56 client hospitals.

• Worked with onsite Public Benefit Advisors to ensure timely capturing of Medicaid applications by thoroughly reviewing medical records and obtaining and submitting relevant documents to social services.
• Assisted regional facilities by remotely screening discharged patients to see if they met Medicaid or disability guidelines before end of month eligibility expired.
• Was responsible for all disability cases for two level II trauma hospitals, one cardiac care hospital, and one acute care hospital. Converted and certified over $50,000,000 in uninsured accounts.
• Monitored filed applications with weekly reviews to reduce denial and appeal rates.
• Refiled and appealed denied cases until a federal decision had been made.
• Verified insurance on case-by-case basis to reduce account volume for the Medicaid eligibility queue.

Pensacola, Florida Area

• Reviewed all referred uninsured in-house patients for potential state and federal assistance programs by identifying qualifying conditions for a 515 bed hospital.
• Submitted inpatient applications directly to social services on behalf of the qualifying patients. Followed application statuses to completion and updated accounts with verified insurance information.
• Reviewed all inpatient admissions, identified and ensured accurate records of all medicaid primary and secondary eligibility days. Assisted patients with appeals process if benefits were denied.
• Exceeded facility productivity goals for retro reimbursement quotas and recovered over $35,000,000 for uninsured accounts by obtaining retro coverage for eligible patients.
• Maintained knowledge of all state and federal program requirements; shared information with co-workers and supervisors.
• Assisted patients in obtaining commercial coverage through the ACA marketplace.

Pensacola, Florida Area

• Worked with case management and the insurance verification department to generate precertification reports and verified insurance information.
• Ran financial analysis and collected estimated patient liabilities for all in-house patients. Met and exceeded monthly collection goal of $18,200.
• Posted ER and Patient Access deposits into PA system daily.
• Responsible for daily cash collections for all hospital departments. In excess of $1,000 per day.
• Contacted insurance companies to determine patient benefits and precertification requirements.
• Coordinated with Public Benefit Advisors to help identify patients that may be eligible for medicaid or other state aid programs.

Pensacola, Florida Area

• Registered 45 or more patients per shift in under 3 minutes while obtaining new or updated demographic information.
• Verified insurances and informed patients of any financial responsibilities.
• Collected patient responsibilities and accurately update their accounts to reflect collections. Exceeded monthly collection goal of $5,500.
• Admitted patients through the ER with faxed orders and transported direct admission patients.
• Responded to ER department phone calls and provided assistance to callers with relevant information.
• Maintained high standards of accuracy and collection of signatures pertaining to registration and admissions.

Chevy Chase, Maryland

• Assisted in the preparation of probate documents for court filing and provided support for trust and estate accounting.
• Drafted memos ranging from property taxes to family law issues and performed revisions on estate trust.
• Responsible for prepping, scanning and indexing legal documents.
• Organized file systems to ensure document accountability for 550 clients.
• Assisted with the organization and filing of client balance reports.
• Covered front desk duties including directing incoming calls, stamping receipts, organizing certified mailings for each attorney, and greeting clients.

Washington, District Of Columbia

• Congressman David W. Jolly (FL-13)
• Interacted with 25 or more constituents a day by phone and responded to their inquiries.
• Directed all other telephone traffic to the proper staff member.
• Processed flag requests.
• Scheduled U.S. Capitol and White House tours.
• Processed incoming mail and assisted with batching intranet mail.

Tampa/St. Petersburg, Florida Area

• Interacted with 15 or more patients per day, by phone and in-person, regarding financial questions or concerns. Responded promptly to all customer needs and questions, occasionally resulting in patient liability plans.
• Liaison with billing company to resolve all situations that affected or delayed submission of claims.
• Responsibilities included: patient registration, posting patient and insurance payments, managing patient accounts, and ensuring electronic medical records were current for over 130 active patients.
• Prepared reports for front desk staff to ensure patient liability is collected.
• Evaluated accounts for charity and made recommendations to senior management.
• Prepared, reviewed, and sent 20 or more patient statements a week.

Health Care Administration Specialization, Health/Health Care Administration/Management

Activities and Societies: Treasurer of the JSA

Dual Enrollment, 12Th

High school dual enrollment program.