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Skills

  • Collaborative teamwork
  • Regulatory compliance
  • Budgets
  • Compliance audits
  • Documentation and paperwork
  • System equipment
  • Cross-functional collaboration
  • Empathetic communication with clients
  • Creating and maintaining client records
  • MS Office

Work Experiences

  • Collaborated with external partners.
  • Coordinated with social workers and legal teams to ensure accurate eligibility assessments, particularly in medically complex cases.
  • Identified job seekers who were having difficulty finding work and devised strategies to help them succeed.
  • Achieved results within 2018.
  • Contributed to a 79% increase in program enrollment.
  • Conducted routine eligibility determinations audits.
  • Chose qualified applicants to refer to potential employers for job placement.
  • Used social media platforms such as standard and category to promote and market services.
  • Achieved 3 successful appeal cases.
  • Achieved results within a three years.

Summaries

  • Accomplished in training new eligibility officers, streamlining onboarding processes to improve speed and knowledge retention by 39% within the team.
  • Aligned decisions with federal and regional regulations.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Adeptly facilitated complex client cases.
  • Talented performer who has provided information, direction, and resource material for over 7 years.
  • Supportive Eligibility Specialist with a strong commitment to customer service and extensive application engagement.
  • Collaborative problem-solver focused on public benefits programs.
  • Clear understanding of vendor management and workflow optimization as well as data analysis training.
  • State Eligibility Consultant with 9 years of successful client relations and cross-functional collaboration experience.
  • Advised on state eligibility policy changes.

Accomplishments

  • Counseled clients on their eligibility status, resulting in 2 successful claims appeals and ensuring continued benefits.
  • Created comprehensive reporting on eligibility trends for stakeholders, utilized during program discussions to drive action plans.
  • Led a complex eligibility case review resulting in a 29% approval rate on appeal cases, boosting client satisfaction in Raleigh.
  • Trained 9 new eligibility representatives, reducing complaint resolution time by 58% within three years.
  • Provided mentoring to less experienced eligibility consultants, reducing overall processing errors by 57%.
  • Achieved a 66% reduction in case handling time by streamlining communication workflows.
  • Collaborated with internal teams to identify gaps in eligibility processes, achieving a 85% reduction in complaint escalations.
  • Created onboarding materials and training programs, decreasing new hire training time by 63% for eligibility officers.
  • Assessed and processed over 17 new claims per week, consistently meeting or exceeding review benchmarks.
  • Provided ongoing eligibility counseling sessions that increased the overall appeal success rate by 29%.

Affiliations

  • American Marketing Association
  • National Welfare Fraud Association (NWFA)
  • National Association of County and City Health Officials (NACCHO)
  • Healthcare Information and Management Systems Society (HIMSS)
  • National Disability Rights Network (NDRN)
  • Certified Professional in Eligibility and Enrollment (CPEE)
  • State Policy Network (SPN)
  • National Association of State Units on Aging and Disabilities (NASUAD)
  • Association for Community Affiliated Plans (ACAP)
  • Employment and Training Administration (ETA) framework

Certifications

  • FMLA/ADA Compliance Certification initiative
  • Certified Healthcare Access Manager (CHAM) - Brightline
  • CompTIA Network+
  • Google Certified Professional Cloud Architect
  • CRA (Certified Risk Analyst) Designation Northwind
  • PROC (Process Optimization Consultant) Certification Vantage
  • CompTIA Security+
  • Certified Customer Service Professional (CCSP) - Harbor & Co.
  • Certified Master Trainer (CMT) by framework 2019
  • Microsoft Certified Systems Engineer (MCSE)

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