anila revised resume for 2016 a-1
TRANSCRIPT
ANILA SMITH10112 Clark Street, Philadelphia, PA 19116
* Over twenty years of community and family outreach and over five years of billing service experience. Proven results-oriented leader and creative problem-solver; Extensive experience managing the day-to-day operations of unit personnel; Working Knowledge of community resources and how to access services for families and children.
EDUCATION Master of Health Administration University of Phoenix Levittown, PA 2009 B.S. Human Resources Geneva College Beaver Falls. PA 1997 A.A. Psychology Philadelphia, PA 1991 Certificate of Health Insurance Russ Financial Schools, Philadelphia, PA 2008
EMPLOYMENT EXPERIENCE
NHS Eearly Intervention Langhorne PA 2014-PresentServices Coordinator
Provides general service management and screening which includes intake, education (services available and application procedures, developmental assessment) and referral of residents to service providers in the general community, emergency assistance).
Monitors the ongoing provision of services from community agencies and keeps the case management and provider agency current with the progress of the individual. Manages the provision of supportive services; where appropriate.
Serves as a liaison to community agencies, networks with community providers and seeks out new services available to the residents.
Provides Community enrichment groups; home visits and parent groups; transition assistance
Allegheny Valley SchoolBehavioral Health Specialist 1998-2002
Evaluation of MR clients, writing and implementing goal plans based on each client needs, charting any medical changes in client due to meds or physical disabilities
Supervised staff on all activities including daily living with clients, training staff on all paper work pertaining to facility requirements; Lead the interdisciplinary process in assessing the desires, strengths, and needs of the individuals in Residential service; Developed goals and objectives, and evaluated progress toward independence
Oversee and work with the various department heads to ensure goals are met and files are processed in accordance with agency and state mandates
Modify treatment activities and approaches as needed in order to comply with changes in clients’ status
Learn about new developments in their field by reading professional literature, attended courses and seminars, and established and maintained contact with other social service agencies
AmeriHealth, Philadelphia PA 2013-2013 Provider Claims Service Representative:
Identifies problems and adjust work activities in accordance to departmental process Follows internal process and procedures to ensure activities are handled in accordance with
departmental and company policies/procedures; Reviews Claims and applies processing rules to determine allowable benefits for payment.
Reviews services for appropriateness of charge and medical necessity and ensures that prior authorizations and precertification guidelines are implemented
Determines file, as appropriate to support payments decisions.
Anila Smith (cont’d)
PHMC, Philadelphia PA 2009-2010Supports Coordinator:
Reviewed all case managements plans with outside agencies; Provided Grant information and resources to families of youths and other care providers
Assisted with placement options to children and youths (PUNS review and Waivers’) Manage and maintain the program database and ensure its accuracy (HICS) Coordinated with clients and third party payer sources Collected, recorded, and handled status of payments Assists team in sourcing potential opportunities and outreach events to clients Set up training workshops for staff Assist in overall mission and goals of the agency
Delta Community Support, Feasterville, PA 2006 –2008Project Director:
Supervised, trained, and provided administrative direction to 30-staff team in residential setting Knowledgeable in assessment, intervention, policy, procedure, compliance, and confidentiality
of financial arrangements Negotiated residential service contracts with sponsors and group home providers Perform compliance audits, checking accuracy of information and eligibility Managed collecting and recording of payments in conjunction with reviewing insurance claims
and forms Plan and manage monthly committee meetings, including agenda, and minutes Manage scheduling of client site visits and conducts site visits as needed Prepare and submit reports to agency director
Little World Family Daycare, Philadelphia, PA 2003-2006Owner and Operator:
Intake of client information for city records, such as health information, emergency contacts information and other miscellaneous forms for maintenance of license
Manage all HR activities, provided personnel assistance in identifying, evaluating, and resolving human relations and work performance problems within the company
Facilitate communication and improved employee-human relations skills Participate in resolving labor relations issues and assisted in screening applicants for training
programs