1. 1MAGEELA WHEELER
4350 Van Vleet Residence: 810-625-2069
Swartz Creek, MI 48473 Email: mwheeler8585@yahoo.com
CAREER SUMMARY
Healthcare professional fluent in Medicare Advantage/Enrollment process and regulations with presently
nine years experience. Extensive knowledge of the Medicare Managed Care Manual Chapter 2 and/ or
Prescription Drug Benefit Manual Chapters 3 and 4. A financial services and payroll professional with
seven years experience in banking operations. Proven ability working with Electronic Funds Transfers.
Demonstrated skills in to processing and transmitting information to clients. Recognized as a dependable
and responsible team player who thrives in challenging situations which require the ability to learn new
skills. Strong research and problem solving skills.
PROFESSIONAL EXPERIENCE
HEATHPLUS OF MICHIGAN, Flint, Michigan 2004-current
$10 million Community-Based Health Plan
Enrollment Reconciliation Coordinator 2005-current
Responsible for process of the Daily Transaction Reply Report (TRR) submissions from CMS and conduct
enrollment reconciliation of Medicare Advantage membership using CMS Reports. Reconcile commercial
premium payments received from large employer groups with premiums billed in Amisys system. Preform
audits pertaining to Medicare Advantage such as Low Income Subsidy (LIS), Best Available Evidence
(BAE), Late Enrollment Penalty (LEP), and SSA Withholding. Perform other reconciliation and
operational functions relating to Part D as required.
• Develop and maintain a strong working knowledge of all systems, software, websites and reports
utilized in Enrollment processes and maintain a very strong understanding of Medicare enrollment and
reconciliation procedures.
• Remain current in knowledge of Medicare regulations by reading, interpreting and analyzing regulatory
bulletins, memos and other updates.
• Established and documented new procedures related to the reconciliation of Medicare Advantage.
• Conducting monthly audits for Medicare Advantage lines of business as prescribed by CMS. These
audit and reconciliation activities include but are not limited comparing CMS reports from Marx to the
Healthplus membership and billing system. All discrepancies identified are resolved by researching
and updating AMISYS and/or submitting record corrections to CMS.
• Coordinate the timely transmission and receipt of Plan data to/from CMS maintain compliance with and
adherence to regulatory requirements.
Enrollment Analyst 2004-2005
Responsible for the accurate and timely processing of enrollment eligibility (paper, fax and electronic) for
all lines of business. Analytical/problem solving skills to research/process/resolve membership issues with
customers. Monitor the timely receipt of enrollment data, applications and EDI files.
• Respond to and assist groups/individuals through written and verbal communication to resolve
membership issues.
• Provide internal enrollment/membership support to all HPM departments, senior management,
governmental agencies and employer groups. Contact may include meetings with internal and external
customers, as well as, on site visits.
2. • Creating and maintaining spreadsheets to better track the incoming and completion of files.
Mageela Wheeler Page Two
CITIZENS BANK, Flint, Michigan 1995-2003
$8 billion bank holding company.
ACH / Cash Management Support Supervisor 2002-2003
Responsible for the daily processing of client electronic cash management files, creating software
media configurations and client set-up for payrolls and billing purposes. Completed, research work
for customers on electronic deposits. Supervised four to five employees in their daily functions.
Hired and trained personnel. Conducted annual staff reviews.
• Transmitted and setup payroll for over 400 companies on the Fundtech system and over 300
companies on the Business Internet system adhering to time restraints.
ACH / Cash Management Support Services Team Leader 1999-2002
Performed a variety of duties to ensure efficient and accurate processing of electronically generated
ACH transactions and files, ensuring that files balanced correctly.
• Researched and resolved complex items, including government reclamations, communicating with
government agencies for re-credits and returns through ACH and Federal Reserve systems, and
ensuring issues and items were cleared in an appropriate time frame.
ACH Services Representative 1997-1999
Balanced and verified the ACH posting for the Corporation, internally generating transactions and
Federal Reserve transactions received or originated. Provided clients and bank personnel with
assistance which included identifying and researching account problems.
Bank Teller 1995-1997
Responsible for Daily Cash Balancing, ATM Balancing, Vault coin inventory, expanding customer
base through in-depth knowledge of retail services, products and selling techniques, processing
financial transactions in an accurate and timely manner. Providing quality customer service.
EDUCATION
Diploma, Flint Northwestern High School, Flint, Michigan 1985
Business Administration, Mott Community College, Flint, Michigan (one semester) 1986
Accounting Fundamentals, Center for Banking Education, Flint, Michigan (10 week course) 1999
Additional Education And Training:
Microsoft Word Fundtech System
Microsoft Excel Software of ACH/Cash Management
Microsoft PowerPoint Data Entry
Typing 45wpm Ten Key Adding Machine
Fedline Amisys