Medicaid Eligibility Specialist Resume
Headline : Self-starter with the ability to problem solve, increase productivity and decrease variances, along with strong training and education in implementing techniques.
Skills : Workers Compensation, Benefits Administration.
Description :
- Interviewed and investigated applicants and recipients to determine eligibility for use of social programs and agency resources.
- Recorded and evaluated personal and financial data obtained from individuals.
- Initiated procedures to grant, modify, deny, or terminate eligibility for various aid programs.
- Complete dand research potential financial resources for the Families/Children served.
- Coordinated eligibility determinations and other related activities associated with Medicaid benefits.
- Provided liaison services between the Alabama Medicaid Agency, Veterans Administration, Social Security.
- Completed documentation reports of individuals submitted for benefits.
- Maintained compliance with policies outlined by state, local, and federal regulations.
Experience
5-7 Years
Level
Executive
Education
Human Services
Medicaid Eligibility Specialist/Representative Resume
Summary : Dedicated and focused Customer Service Rep who excels at prioritizing, completing multiple tasks simultaneously. Specialize in Administrative support to a busy security office.
Skills : Technical Skills, Critical Thinking.
Description :
- Provided consultation and technical assistance to a nursing home, hospital, hospice, and rehabilitation services personnel and family members.
- Served as a liaison with the community, state and federal agencies to coordinated client benefits and services.
- Interviewed clients/their representatives to determine initial and Medicaid programs for the aged, blind, and disabled.
- Scheduled appointments by written notices and telephone contacts.
- Conducted in-depth personal interviews with clients and representatives.
- Obtained pertinent information related to eligibility factors based on policies and procedures.
- Identified clients' needs and made appropriate referrals to community resources and public services.
Experience
7-10 Years
Level
Management
Education
Business Management
Medicaid Eligibility Specialist III Resume
Summary : Eligibility specialists determine whether or not applicants for various programs meet the necessary qualifications.
Skills : Medical Terminology, Telemarketing, Customer Service.
Description :
- Analyzed problems by evaluating available information and resources.
- Calculated applicant eligibility by using basic mathematical operations.
- Developed effective, viable solutions to problems that can help drive the effectiveness of the department.
- Developed referral networking systems by initiating and maintaining contact with community partners.
- Consistently delivered required business results; sets and achieves achievable, yet aggressive, goals.
- Maintained focus on Agency and State goals.
- Worked with team members to develop, organize, and implement organizational activities.
- Demonstrates consistently the ability to interface with a wide range of personnel with tact.
Experience
10+ Years
Level
Senior
Education
Masters
Medicaid Eligibility Specialist/Co-ordinator Resume
Summary : Seeking a full time position in public health or related field. Usually they work with government aid, especially in the health care industry, like Medicare or Medicaid.
Skills : Management Skill, Inventory, Accounts Payable.
Description :
- Worked involves interviewing clients, documenting information gathered.
- Determined benefits, verifying case data, explaining program benefits and requirements.
- Reviewed eligibility of clients for ongoing services.
- Interviewed clients or authorized representative to gather information to determine eligibility for benefits.
- Conducted reviews to determine or verify eligibility or continued eligibility and benefit level.
- Processed changes to client status, overpayments, and adjusts or restores benefits.
- Obtained, verified, and calculated income and resources to determine client financial eligibility.
- Documented case records using automated equipment to form a record for each client.
Experience
7-10 Years
Level
Management
Education
Bachelor Of Arts
Medicaid Eligibility Specialist I Resume
Objective : Friendly office assistant with extensive experience dealing with Medicaid, Medicare, Social Security, VA and Clark County. Skilled at communicating and developing professional relationships.
Skills : Business Applications, Record keeping, Keyboarding.
Description :
- Assumed responsibility for approximately ongoing and pending Medicaid and County cases.
- Met with the resident or their representative to review the resident's financial situation and determine which medical assistance program was appropriate.
- Completed medical assistance application; acquired necessary documents, releases, and signatures.
- Prepared written communications to advise the resident or their representative of further required documentation.
- Submitted the medical assistance application and required documentation in a timely manner to the appropriate agency.
- Contacted various program caseworkers. Determined eligibility for Medicaid.
- Completed applications, budgets, and interviews.
Experience
2-5 Years
Level
Junior
Education
Diploma
Sr. Medicaid Eligibility Specialist Resume
Summary : To become an effective member of a goal oriented organization that will take advantage of organizational and leadership skills to meet agency objectives.
Skills : Creativity, Adobe Photoshop, Adobe Illustrator.
Description :
- Compiled information necessary to complete referrals for the elderly waiver program.
- Compiled information needed to determine eligibility for the elderly waiver funded through Medicaid.
- Verified documentation of the financial need for payment of services.
- Acted as a liaison between applicants and the Department of Human Services.
- Provided initial applications and documentation to Medicaid eligibility workers.
- Maintained dialogue with income maintenance workers from the Department of Human Services regarding eligibility for the program.
- Maintained an extensive knowledge of Medicaid eligibility policies.
- Maintained strong working relationships with personnel from area health agencies and the Department of Human Services.
Experience
10+ Years
Level
Senior
Education
Diploma
Medicaid Eligibility Specialist/Executive Resume
Summary : A challenging position as a Medicaid Eligibility Specialist which will allow to both further utilize skills and acquire new abilities.
Skills : Technical Skills, Organized.
Description :
- Specialized the Medicaid unit was located within the University of VA hospital.
- Received possible Medicaid eligible referrals from the UVA Admissions office based on the information given at the time of admission.
- Interviewed patients or family members gather information such as income, resources, and/or other items to determine eligibility.
- Contacted banks, employers, personal property, social security; all to determine patient eligibility.
- Contacted with hospital social workers and admissions office.
- Respected at all times, patient confidentiality.
- Able to relate and correspond with patient and all necessary parties.
Experience
10+ Years
Level
Senior
Education
High School
Lead Medicaid Eligibility Specialist Resume
Summary : To obtain a position which enables to utilize business expertise and strong organizational skills. Medicaid Eligibility Specialist is responsible for developing and implementing the Medicaid eligibility process in the states.
Skills : Medicaid Eligibility Determination, Organized.
Description :
- Met with uninsured hospital patients to review their eligibility for Medicaid and other community-funded resources.
- Analyzed and updated the hospital's electronic health records.
- Provided input for increasing the hospital's Medicaid revenue Preparing daily reports to identify progress towards meeting financial goals.
- Validated and reviewed services rendered by the hospital prior to submitting billing for payment.
- Served as a liaison between Adreima and other organizations such as Social Services.
- Submitted billing to the state or appropriate funding source for payment.
- Updated management on the financial status of unresolved accounts.
Experience
10+ Years
Level
Senior
Education
Management
Medicaid Eligibility Specialist I Resume
Objective : Management experience in a DSS setting and performed follow-up and case maintenance as needed. Medicaid Eligibility Specialist also works closely with providers to ensure that eligibility is maintained and that the provider’s services are covered by the program.
Skills : Analytical Skills, Critical Thinking.
Description :
- Worked with patients who are without private health insurance with application eligibility to various Federal, state, local and private programs.
- Interviewed patients to screen for available services.
- Maintained files to ensure deadlines are met and that the applications are processed in a timely manner.
- Investigated information was given by patients for accuracy.
- Processed hospital Charity Care applications and provide follow-up with patients for additional information, approvals, and denials.
- Maintained patient confidentiality and follow all HIPPA laws.
- Handled cash, check, and credit card payments for medical services.
- Maintained accurate reporting to superiors.
Experience
2-5 Years
Level
Junior
Education
Bachelor's
Associate Medicaid Eligibility Specialist Resume
Summary : Experienced in Microsoft Office Suite, along with standard software and office equipment used in the workplace.
Skills : Technical Skills, Process Management.
Description :
- Worked to help Georgia families obtain access to free and low-cost health insurance.
- Communicated moderately complex information and interacts through electronic documentation tools.
- Experienced in processing P4HB applications for Women's Medicaid, Newborn report, Operation Registration, Spin-Offs.
- Processed standard Medicaid applications, and Short Circuit FFM.
- Referred members to other collaborative programs for extra assistance.
- Operated in Success, Compass, GRITS, The Work Number, Web One, Vida, and UCM.
- Created PDF files, reports, MS Office. Served as team lead when the supervisor is absent.
Experience
10+ Years
Level
Senior
Education
Environmental Science
Medicaid Eligibility Specialist Resume
Summary : Medicaid Eligibility Specialist is responsible for helping State Medicaid agencies meet their eligibility requirements.
Skills : Analytical Skills, Management.
Description :
- Managed over active cases with recipients. Responsible for the calculation of budgets.
- Handled irate/difficult clients and providers to diffuse potentially volatile situations and to render services.
- Communicated orally in a one-on-one situation to conduct client interviews.
- Provided and gathered program information and explain results.
- Organized information to ensure efficient office operation and case management.
- Communicated orally in group situations to make presentations and conduct group interviews.
- Operated a computer to include operation, maintenance, and troubleshooting to perform job duties.
Experience
7-10 Years
Level
Management
Education
Certificate
