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Enrollment and Reconciliation Specialist

Bronx, NY


To acquire a position in a company that offers potential for future growth using my communication and organizational skills. I work extremely well with others and enjoy a challenge.

Work Experience

Enrollment and Reconciliation Specialist

Corporate Care Management
Bronx, NY

July 2011 to Present

Darrell J. Carrington 
855 E 233rd St Apt 8A * Bronx, NY 10466 * (347) - 393- 1725 * 
Gained solid experience in Managed Long Term Care operations where consistent performance, fast clear decision making and technical expertise were developed. During this time I became proficient in all areas involving enrollment and disenrollment of MLTC members.  
Enrollment and Reconciliation  
• Executed enrollment and disenrollment for members of Managed Long Term Care plan Direct Complete 
• Provided enrollment and disenrollment reconciliation of members on a daily basis through use of eChamp, EPACES and MARX 
• Responsible for member mailings of enrollment, disenrollment, and insurance notifications. 
• Converted Transaction Reply Record into excel spread sheet and updated Master Enrollment report daily 
Weill Cornell Medical College December 2010 –JULY 2011 
Primary Care Department  
• Primary duty to schedule appointments for Pediatrics, OB/GYN, and Internal Medicine 
• Entered demographic information  
• Liaison between patients and nurses for doctors 
ARCH CARE ADVANTAGE September 2008 - November 2010 
Enrollment Specialist/Member Services 
• Executed enrollment of Arch Care Advantage applicants 
• Entered demographic information into Managed Care Optimizer/Primary call center representative 
• Verified applicants Medicaid status through EPACES 
• Coordinated with marketing and nursing home facility to obtain any missing documentation that would prohibit potential member from joining MLTC plan 
• Checked Infocrossing to verify if members had ESRD which would prevent them from joining MLTC plan 
_____________________________________________________________________________________________ EDUCATION 
B.A. Public Relations, Minor Economics, State University of New York at New Paltz (5/08) 
Selected to lead enrollment section of CMS mock audit for Arch Care Advantage 
Chosen by Director of Enrollment to attend CMS Conference of 2009 
Member of Omega Psi Phi Fraternity INC.

Sales Associate

Nine West Jones Apparel Group

April 2002 to January 2005

o Provided customers with assistance 
o Validated daily cash receipts 
o Validated deposit slips 
o Responsible for shipping of customer orders across country 
o Stocked new inventory 
Collegiate Activities: Member of Omega Psi Phi Fraternity Incorporated, Public Relations Chairman of the Student Association of Entertainment at SUNY New Paltz, Treasurer of the Boys to Men Organization, written for the New Paltz newspaper the "Oracle", and member of the Voices of Unity Gospel Choir


Bachelors of Arts in Public Relations

State University of New York
New Paltz, NY



IDX Certified, eChamps, Managed Care Optimizer, Infocrossing

Additional Information

Office Skills 
Obtained extensive knowledge in MS WORD, POWERPOINT, and EXCEL 
Excellent communication skills