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Skills

  • Conflict resolution
  • Business operations
  • Cross-functional teamwork
  • Client communication
  • Client Satisfaction Improvement
  • Compliance certifications (CPA)
  • Applicant engagement
  • Resource information
  • Data analysis for fraud detection
  • Regulatory knowledge

Work Experiences

  • Conducted interviews with applicants and explained the scope of various benefits that were available.
  • Assisted in the successful rollout of a new applicant tracking system, reducing errors in eligibility calculations by 56% within 15 months.
  • Consistently met application processing deadlines.
  • Addressed backlogged cases.
  • Collaborated with internal and external auditors.
  • Coordinated with internal teams and external authorities.
  • Reviewed applications for various aid programs and determined which individuals met the eligibility requirements.
  • Collaborated with supervisors to refine eligibility workflows.
  • Analyzed patterns in eligibility rejections.
  • Achieved results over a 9-month period.

Summaries

  • Committed professional with hands-on experience in process optimization.
  • Dedicated to expanding job opportunities by forging strong bonds with employers and job seekers.
  • Accomplished professional adept at resolving eligibility disputes through in-depth research of historical data and regulations, reducing external appeals by 10%.
  • Professional who can keep accurate records, schedule appointments, and handle a variety of administrative tasks in both English and Spanish.
  • Collaborative leader with expertise in audit readiness, successfully coordinating with auditors to uphold strict compliance and win performance awards in 2019.
  • Client-focused professional skilled in creating seamless eligibility processes, delivering 31% faster turnaround times without compromising compliance.
  • Collaborative leader with expertise in audit readiness.
  • Senior Eligibility Associate with 8 years of successful workflow optimization and stakeholder engagement experience.
  • Achieved a 48% reduction in errors.
  • Client-focused professional.

Accomplishments

  • Improved end-user satisfaction by reducing eligibility determination delays, leading to 17% higher client approval ratings.
  • Championed the transition from paper-based to digital processes, enhancing system accessibility and reducing errors by 34%.
  • Developed and rolled out a new training program which upskilled 16 employees, ensuring compliance with new eligibility regulations.
  • Improved client onboarding procedures by implementing electronic eligibility tools, reducing wait times by 71% across 6 departments.
  • Documented and resolved category which led to process.
  • Collaborated with IT and HR departments to develop automated eligibility workflows, increasing efficiency by 58%.
  • Utilized data analysis to proactively identify procedural gaps, leading to a 42% improvement in fraud detection processes.
  • Collaborated with team of 7 in the development of category.
  • Resolved product issue through consumer testing.
  • Negotiated with 6 third-party vendors for reduced rates on eligibility verification services, cutting costs by $52,000.

Affiliations

  • International Council of Nurses
  • American Association of Healthcare Administrative Management (AAHAM)
  • American Institute of Certified Public Accountants (AICPA)
  • Community Workers Association (CWA)
  • Certified Patient Account Manager (CPAM)—exams administered by AAHAM
  • American Marketing Association
  • National Welfare Rights Union (NWRU)
  • Public Service Workers Union of America
  • National Association of Government Communicators (NAGC)
  • American Medical Informatics Association

Certifications

  • Project Management Professional (PMP)
  • Certified in Disability Management (CDMS) Denver
  • Certified Case Manager (CCM) - Raleigh
  • Certificate in Human Services Eligibility Determination Cedar Works
  • Workers' Compensation Professional Certification (WCP) Harbor & Co.
  • Certified Compliance & Ethics Professional (CCEP) Portland
  • Certified Public Accountant (CPA)
  • Certified Business Analysis Professional (CBAP)
  • Certified Medicaid Eligibility Specialist (CMES) 2019
  • CompTIA Security+

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