Eligibility Coordinator Resume Samples

An Eligibility Coordinator is hired to determine if the applicant for various programs meets the necessary qualifications or not. The job duties commonly listed on the Eligibility Coordinator Resume are – conducting fact-checking, record keeping, and advocacy on behalf of the clients, reviewing applications for various aid programs, verifying the application forms, acting as an information resource, advising people on what aid programs may benefit them; and making sure the application forms are duly filled in all respect.

As a large part of the job includes documentation and paperwork, employers need someone who has computerized record-keeping skills. Besides, the person should be able to keep track of client appointments and stay aware of the program’s eligibility criteria and regulations. A high school diploma may be a sufficient educational qualification. However, awareness of the institution and its policies are crucial.

 

Eligibility Coordinator Resume example

Eligibility Coordinator Resume

Objective : Seeking an Eligibility Coordinator position in a professional organization where growth is encouraged. Transferable and interpersonal skills earned from previous work experiences will be of an advantage to the company.

Skills : Microsoft Office, Adobe Acrobat, Typing 40wpm, Data Entry, Database Management.

Description :

    1. Scheduled appointments for new clients, as well as for testing.
    2. Audited electronic health records, for clients expiring every 0-30 days.
    3. Displayed professional telephone etiquette when discussing Eligibility, or any other SHF service with clients.
    4. Obtained Ryan White Eligibility documents (proof of diagnoses, income, residence, etc.) annually.
    5. Processed Specialist Referrals (Vision, Dental, etc.).
    6. Initiated follow-up calls for missed appointments.
    7. Verified insurance information using MeditLive, TMHP, Availity, etc.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
MS In Accountancy


Eligibility Coordinator Resume

Headline : Eligibility Coordinator is Leading a team of skilled Medicaid Eligibility Specialists, directing the efforts of Specialists and managing work within the team, Monitoring team member performance on a day-to-day basis, Implementing agency-standard workflow processes and procedures, Providing guidance to team members and agency managers on the effectiveness of agency policies, procedures, and processes, Ensuring Specialists are held accountable to established guidelines for the performance of workplace duties.

Skills : Customer Service, Clerical.

Description :

    1. Processed member applications by reviewing data for deficiencies; assigning codes to data; establishing data entry priorities, and resolving discrepancies by using departmental policies and procedures.
    2. Entered member data by inputting alphabetic and numeric information into IKA system according to screen format including benefit assignment, group affiliation, and provider selection, billing information, revenue codes and appropriate cross references.
    3. Verified eligibility for enrollment using state and Federal websites.
    4. Provided excellent customer services by making a high volume of outbound calls to members to clarify, obtain, and or confirm information needed to successfully complete member's enrollment request.
    5. Accurately interpreted and explained eligibility and CMS regulations and requirements in person, via email or telephonically Prepares member correspondence by creating, triggering, printing, reviewing and mailing.
    6. Assured accurate data from regulatory system reply by utilizing Federal systems and other departmental systems to run reports and collect and analyze data for any necessary updates.
    7. Responsible for employee enrollment in tax-advantaged medical care and benefits accounts, as well as providing consultation to employers Spherion.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Diploma In Communication


Eligibility Coordinator Resume

Objective : Well qualified individual seeking a secure responsible position where I can maximize my multilayer of problem solving skills, educating, training experience, and organization skills. Skilled in tracking data, preparing reports and generating business communications. Considered highly motivated with a strong work ethic.

Skills : Multi-Employer Health Benefits, Defined Benefit Plans, Defined Contribution Plans, Customer Service.

Description :

    1. Provided updates in CPCDMS (Centralized Patient Care Data Management System) of client's FLP, county, income, and residency documents collected for annual audits.
    2. Reconciled discrepancies, between member data and various systems.
    3. Researched eligibility rejected transactions by identifying discrepancies and report findings to the appropriate business area.
    4. Completed applications with patients and processing/sending to the appropriate agencies.
    5. Assisted patients with gathering and sending all requested documents to the requesting agencies.
    6. Determined Eligibility for patients who meet state and government income guidelines.
    7. Followed up on and guiding the patients through the application process.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
High School Diploma

Eligibility Coordinator Resume

Summary : Eligibility Coordinator with 7 years of experience in Receiving and interpreting employee performance reports and provides accurate counselling to Eligibility Specialists in a timely manner, Performing correct administrative follow-up activities after employee counselling and consults human resources when needed to complete employee evaluation or disciplinary action.

Skills : Customer service, Cash collections & Data entry experience.

Description :

    1. Responsible for preparing monthly eligibility for approximately 350 plans and answering any client questions about their eligibility requirements.
    2. Sent an email to our clients with this employee information and according to their responses, I prepare and order enrollment materials for each confirmed eligible employee.
    3. Entered ongoing census updates into our system so that we are able calculate eligibility as accurately as possible.
    4. Updated participant data on the investment company websites, as well (name changes and address updates).
    5. Responsible for updating plan changes regarding eligibility into our software system (PensionPal and FT William).
    6. Logged distribution requests into our systems for our transaction coordinators, which requires me to multi-task throughout the day.
    7. Referred patients to other organizations for assistance in health care and financial assistance.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Senior
Education
Education
MS

Eligibility Coordinator Resume

Headline : Eligibility Coordinator with 6 years of experience in Identifying and scheduling trainings for employees and identifies high-performing employees as candidates for reward or promotion, Providing positive reinforcement and messaging to employees about departmental goals and standards. Leads a team that meets, in the aggregate, Medicaid Eligibility Specialist performance standards.

Skills : Market Research, Analysis, Data Analysis, Social Media Marketing, Inventory Management, Consulting, Management, Editing, Sales Operations, Customer Service, HTML, UNIX, LINUX.

Description :

    1. Completed client interviews either face-to-face or via phone to determine eligibility for FS, TANF, Medicaid A B or D and IMPACT programs.
    2. Completed client interviews either face-to-face or via phone to re-determine eligibility for FS or TANF programs.
    3. Ensured case information is gathered and processed in a complete and accurate manner in accordance with State policy.
    4. Entered client data into the ICES system.
    5. Assisted clients with understanding their rights and responsibilities.
    6. Assisted clients with obtaining required verification for determining eligibility.
    7. Documented verification of eligibility into the ICES system and summarizes case activity on CLRC or CLSC screens.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
B.A In Political Science

Eligibility Coordinator Resume

Objective : As an Eligibility Coordinator is Providing technical assistance to Medicaid Eligibility Specialists and aids in the resolution of common questions, concerns, and escalations received by Medicaid Eligibility Specialists. Accurately addressing or routing questions and escalations to the appropriate resource including team leads, training staff, or help desk professionals, among others.

Skills : Training, Counselling, MS Office.

Description :

    1. Counselled clients to accept personal responsibility for their actions, consequences and need to comply with the rules and regulations.
    2. Worked assigned alerts, changes and incoming documents daily.
    3. Used Screening patients under the states and government guidelines and statues.
    4. Interviewed and counselled clients Manages caseloads Meets high performance as prescribed by the Pennsylvania Department of Public Welfare.
    5. Maintained the ability to aid clients to receive subsidy.
    6. Communicated with County Assistance Office (CAO) workers.
    7. Counselled clients of their rights and responsibilities as recipients of subsidized child care benefits.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Diploma

Eligibility Coordinator Resume

Objective : Eligibility Coordinator with 4 years of experience in Performing fundamental supervisory and leadership functions in accordance with Department policies and procedures, best practices and Federal and State rules and regulations, especially with regard to Equal Employment Opportunity Commission (EEOC) standards, Maintaining an effective organisational team and motivates diverse staff to accomplish mission critical operations and objectives.

Skills : Experience With Windows Based Software, Internet, Word, And Excel., Proven Ability To Initiate, Maintain And Develop Positive Business Relationships., Excellent Communication Both Verbal And Written.

Description :

    1. Effectively communicated with outside agencies. 
    2. Utilized web-based databases including to store/ review client data and determine client eligibility.
    3. Maintained judgment and analytical skills; regarding eligibility determination for the state subsidy program, while supporting and integrating with all CCIS units.
    4. Counselled clients of their rights and responsibilities as recipients of subsidized child care benefits through individual conferencing, phone communication, and by written correspondence.
    5. Planed, organized, processed and managed caseloads to ensure timely eligibility determination and ongoing case management within DPW regulated time frames.
    6. Communicated effectively with outside agencies, including other CCISs, CAO offices, EARN centers and childcare providers.
    7. Utilised web-based databases, PELICAN and CIS to store/review/update client data and determine client eligibility.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
AS In Business

Eligibility Coordinator Resume

Objective : Eligibility Coordinator with 3 years of experience in Attending meetings and training sessions as required, Making and keeping schedules, completes tasks timely and reports to work timely, Assisting eligibility management and senior leadership with projects as assigned, Performing related duties as assigned or required.

Skills : Data Entry, Customer Service, Trainer, Receptionist, 10 Key, Keyboard.

Description :

    1. Answered incoming calls from providers and patients.
    2. Met high performance standards to compile data as prescribed by the Pennsylvania Department of Public Welfare while maintaining the ability to aid clients to receive subsidy.
    3. Participated in YWCA and DPW professional development opportunities successfully implementing new skills, knowledge and procedures.
    4. Customised eligibility reports, performed quality assurance reviews for data entry operators, weekly productivity reports, training new data entry operators.
    5. Contracted medical providers and patients to expedite claim processing as needed.
    6. Performed many microfilming functions.
    7. Developed and implemented procedural changes as required.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
BA

Eligibility Coordinator Resume

Objective : A forward-thinking and resourceful customer service professional with a demonstrated track record in sales, operations analysis, technical support, call centers, implementations and integrations, computer operations, application development and services, system and database management, and training and development.

Skills : CPR, Dry Needle Certified, Resource Management.

Description :

    1. Interpreted and implemented guidelines set by federal, state and local directives and regulations of programs managed by WNi.
    2. Determined general and economic eligibility of applicants, using analytical skills, simple mathematical calculations.
    3. Interviewed applicants to determine eligibility and determine suitability.
    4. Contacted other agencies and individuals to collaborate or obtain information relevant to eligibility determination.
    5. Coordinated resources with other agencies.
    6. Administered, interpreted and evaluated testing instruments to ensure applicants meet basic education requirements and are suited for their career choice.
    7. Provided assistance, counseling and support to applicants.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
MS

Eligibility Coordinator Resume

Objective : To obtain an Eligibility Coordinator position responsible for Loading and update member information while maintaining less than a 2% error rate, Resolving complex issues from the call center in regards to a members claim that was rejecting, Processing confidential patient information by email, task, and phone while maintaining a two-hour turnaround time, Researching and resolving issues while documenting new issues and resolution.

Skills : Microsoft Office, Type 70 wpm, Legal Research, GBAS.

Description :

    1. Managed a caseload of approximately 300 families, effectively and efficiently.
    2. Distributed subsidized funds to families and providers in an accurate and timely manner.
    3. Interviewed clients to assure they met the Federal Poverty Income guidelines.
    4. Interacted daily with child care providers, employers and schools to verify employment status of clients.
    5. Conducted training of participants as to program rights, regulations and responsibilities as recipients of subsidized child care benefits.
    6. Calculated and entered client income information into State computer data management system.
    7. Assured case compliance with the Department of Public Welfare rules and regulations.
    8. Participated in hearings alongside the Office of the Inspector General after discovering fraudulent activity committed by clients and/or childcare providers.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
GED