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Brock Walker
Eligibility Clerk
Summary
Highly skilled and experienced Eligibility Clerk with a proven track record of providing excellent customer service while ensuring accurate and timely eligibility determinations for various healthcare programs, including Medicaid and Medicare. Proficient in interpreting policies, reviewing documentation, and analyzing complex eligibility issues. I am committed to upholding high quality standards and meeting deadlines. Possess strong data entry and problem-solving skills, allowing me to manage a high volume of applications and collaborate effectively with healthcare providers and social workers.
Education
Healthcare Administration
November 2018
Skills
- Eligibility Determination
- Policy Interpretation
- Documentation Review
- Customer Service
- Data Entry
- Problem Solving
Work Experience
Eligibility Clerk
- Collaborated with healthcare providers and social workers to ensure accurate and timely eligibility determinations
- Managed caseloads effectively, meeting deadlines and maintaining high quality standards
- Resolved complex eligibility issues through research and analysis
- Provided excellent customer service to applicants and external stakeholders
Eligibility Clerk
- Verified eligibility for Medicaid and Medicare benefits for over 5,000 applicants per year
- Processed applications and determined eligibility based on income, household size, and other factors
- Interviewed applicants inperson and over the phone to gather necessary information
- Utilized various software and databases to retrieve and manage applicant data
Accomplishments
- Successfully processed over 1,000 eligibility applications per month, exceeding the department average by 15%
- Developed and implemented a new workflow process that reduced application processing time by 10%
- Collaborated with other departments to streamline data sharing, improving the accuracy of eligibility determinations
- Conducted training sessions for new eligibility clerks, ensuring they are wellequipped to handle complex cases
- Developed a database that tracks key performance indicators, enabling datadriven decisionmaking
Awards
- Received the Eligibility Excellence Award for outstanding performance in determining eligibility for benefits
- Recognized by the National Association of Eligibility Clerks (NAEC) for contributions to the field
- Named Employee of the Year for consistently exceeding expectations in the Eligibility Department
- Received a Certificate of Appreciation from the Department of Health and Human Services for contributions to the Medicaid program
Certificates
- Certified Eligibility Professional (CEP)
- Certified Professional Coder (CPC)
- Certified Medical Assistant (CMA)
- Certified Case Manager (CCM)
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How To Write Resume For Eligibility Clerk
- Showcase your strong knowledge of eligibility guidelines and regulations.
- Highlight your ability to interpret complex policies and make accurate eligibility determinations.
- Emphasize your commitment to providing exceptional customer service and building rapport with applicants.
- Demonstrate your proficiency in data entry and management, as well as your ability to work independently and as part of a team.
Essential Experience Highlights for a Strong Eligibility Clerk Resume
- Verified eligibility for Medicaid and Medicare benefits for over 5,000 applicants per year, ensuring accuracy and compliance with program guidelines.
- Processed applications and determined eligibility based on income, household size, and other eligibility criteria, ensuring timely and fair determinations.
- Interviewed applicants in person and over the phone to gather necessary information, effectively communicating complex eligibility requirements and resolving queries.
- Utilized various software and databases to retrieve and manage applicant data, maintaining confidentiality and integrity.
- Collaborated with healthcare providers and social workers to exchange information, verify eligibility, and ensure continuity of care.
- Managed caseloads effectively, meeting deadlines and maintaining high quality standards, prioritizing tasks and managing time efficiently.
- Resolved complex eligibility issues through research, analysis, and consultations with supervisors and subject matter experts.
Frequently Asked Questions (FAQ’s) For Eligibility Clerk
What are the primary responsibilities of an Eligibility Clerk?
Eligibility Clerks are responsible for verifying and determining the eligibility of individuals for various healthcare programs, ensuring that they meet the necessary criteria and documentation requirements.
What skills are essential for an Eligibility Clerk?
Essential skills for Eligibility Clerks include strong communication and interpersonal skills, proficiency in data entry and management, knowledge of eligibility guidelines, and the ability to interpret complex policies and make sound judgments.
What is the career path for an Eligibility Clerk?
Eligibility Clerks can advance to roles such as Eligibility Supervisor, Healthcare Program Specialist, or Case Manager, with further experience and qualifications.
What is the job outlook for Eligibility Clerks?
The job outlook for Eligibility Clerks is positive due to the increasing demand for healthcare services and the need for qualified individuals to determine eligibility for various programs.
What are the educational requirements for an Eligibility Clerk?
Eligibility Clerks typically require a high school diploma or equivalent, with some employers preferring candidates with an associate degree or certification in healthcare administration or a related field.
What is the average salary for an Eligibility Clerk?
The average salary for Eligibility Clerks varies depending on experience, location, and employer, but typically ranges from $30,000 to $50,000 per year.
What are the benefits of working as an Eligibility Clerk?
Benefits of working as an Eligibility Clerk include job security, opportunities for career advancement, the chance to make a positive impact on the lives of others, and the satisfaction of helping individuals access essential healthcare services.