Chanin Cummings

Case Manager @Gainwell Technologies

US

Manage reimbursement cases for Medicaid recipients enrolled in employer-sponsored commercialinsurance, ensuring compliance with HMS (Health Management Systems) guidelines.• Review and validate documentation, including paystubs, proof of payment, Medicaid verification, andsupporting documents, to determine eligibility for reimbursement.• Conduct case evaluations to ensure cost-effectiveness and accuracy prior to payment approval.• Process and batch payment vouchers for eligible applicants during scheduled Checkrun cycles.• Accurately enter and update sensitive case data using Perceptive and Pier systems, managing a high-volume caseload of approximately 60 cases per day (300+ weekly).• Collaborate with cross-functional teams and leadership to support timely case resolutions in a fast-paced, high-volume environment.• Maintain confidentiality and adhere to HIPAA compliance standards throughout all case managementactivities.