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Skills

  • Operational improvement
  • Client interview techniques
  • Problem resolution
  • Eligibility Determination
  • Case management
  • Budgets
  • Administrative hearings representation
  • Cross-functional team collaboration
  • Client Satisfaction Improvement
  • Process optimization

Work Experiences

  • Applied state and federal regulations.
  • Communicated with people from various cultures and backgrounds during the application process.
  • Documented accurate descriptions of required job duties, working hours, and wages by writing job orders for employers.
  • Conducted investigations for fraud detection.
  • Analyzed discrepancies in data.
  • Collaborated with external providers.
  • Analyzed program data.
  • Assessed applicants' financial data.
  • Conducted interviews with applicants and explained the scope of various benefits that were available.
  • Created procedural documentation for eligibility verification processes.

Summaries

  • Professional with experience in job interview techniques and QuickBooks who is responsive and dependable.
  • Through dynamic communication and exemplary engagement skills, a confident Eligibility Specialist is committed to promoting positive customer outcomes.
  • Accurately processed applications.
  • Considered a team player who excels at multitasking.
  • Boosted team efficiency by 40% %.
  • Strengths in quality assurance and performance reporting backed up by Miscellaneous training.
  • Committed Eligibility Examiner who excels in cross-functional collaborations, actively participating in outreach initiatives that boosted program applications by 84% among underserved populations.
  • Analytical Eligibility Examiner.
  • Boosted enrollment among eligible populations by 39%.
  • Professional who is well-organized and has excellent communication and multitasking skills.

Accomplishments

  • Mitigated potential fraud risks by developing investigative reports on suspicious applications, leading to a 26% increase in fraud detection.
  • Provided case management and eligibility determination for 9 clients weekly, achieving consistent and timely approval rates.
  • Analyzed complex cases and collaborated with legal and compliance teams to ensure correct eligibility classifications, reducing benefit delivery delays by one year.
  • Implemented a new reporting mechanism that improved case closure rates by 52% over a period of two years.
  • Assisted in the implementation of compliance initiatives that lowered the error rate in eligibility determinations by 84% over the past year.
  • Reviewed and processed over 17 eligibility applications per week, ensuring adherence to category guidelines and reducing processing time by 54%
  • Consistently achieved a processing accuracy rate of 15% by methodically verifying applicant documentation across 2 programs per month.
  • Collaborated across departments to improve the accuracy of eligibility determinations, reducing escalated cases by 41%.
  • Researched and applied knowledge of local, state, and federal regulations to ensure 15% compliance in eligibility determinations across the Southwest jurisdiction.
  • Reduced errors in benefit eligibility processing by developing and implementing standardized workflows, decreasing repeat audits by 32%.

Affiliations

  • Association for Computing Machinery
  • American Marketing Association
  • Association for Supply Chain Management (APICS)
  • American Society of Safety Professionals
  • National Association of Professional Background Screeners
  • Association for Community Affiliated Plans
  • Toastmasters
  • Institute of Internal Auditors
  • Freemason
  • National Employment Law Project

Certifications

  • Certified Medicaid Planner (CMP)
  • SHRM Certified Professional (SHRM-CP)
  • Federal Public Assistance Management Certification
  • Certified Compliance and Ethics Professional (CCEP)
  • Certified Public Manager (CPM)
  • Public Assistance Eligibility Worker Certification from Illinois
  • Social Services Eligibility Certification (SSEC)
  • Certified Welfare Fraud Investigator (CWFI)
  • ServSafe
  • CompTIA A+ Technician

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