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Eric Howard
Eligibility Services Representative
Summary
Highly accomplished Eligibility Services Representative with 5+ years of experience in processing over 1,200 eligibility applications per month. Proven ability to conduct comprehensive income and asset assessments, determine eligibility for various programs, and collaborate with healthcare professionals. Expertise in interviewing applicants, collecting information, and making eligibility determinations for social services. Strong understanding of state and federal regulations, exceptional communication skills, and proficiency in case management software.
Education
Social Work
November 2018
Skills
- Eligibility Determination
- Benefits Analysis
- Case Management
- Interviewing and Assessment
- Policy Interpretation
- Program Compliance
Work Experience
Eligibility Services Representative
- Developed and implemented process improvements to streamline eligibility application processing.
- Provided exceptional customer service, effectively communicating with applicants and resolving inquiries promptly.
- Utilized case management software to track applications, manage caseloads, and ensure timely followups.
- Collaborated with other departments, such as legal, finance, and IT, to ensure seamless eligibility determination processes.
Eligibility Services Representative
- Processed over 1,200 eligibility applications per month, ensuring accuracy and compliance with state and federal regulations.
- Conducted comprehensive income and asset assessments to determine eligibility for various programs.
- Reviewed medical documentation and collaborated with healthcare professionals to verify eligibility for health insurance programs.
- Interviewed applicants, collected information, and made eligibility determinations for social services.
Accomplishments
- Successfully processed and approved over 10,000 Medicaid applications, ensuring timely access to healthcare coverage for eligible individuals
- Developed and implemented a new workflow that streamlined the eligibility verification process, reducing processing time by 25%
- Trained and mentored a team of eligibility specialists, improving overall team performance and customer satisfaction
- Collaborated with community partners to increase outreach and enrollment efforts, expanding access to healthcare coverage for underserved populations
- Developed and implemented a standardized eligibility assessment tool, ensuring consistency and accuracy in determining eligibility
Awards
- Received the National Association of Medicaid Directors (NAMD) Award for Excellence in Medicaid Eligibility and Enrollment
- Recognized by the state for exceptional contributions to the Medicaid program through innovative and efficient eligibility administration
- Presented with the Agency Award for Outstanding Customer Service for consistently exceeding expectations in assisting Medicaid applicants
- Received the Supervisor of the Year Award for fostering a positive and productive team environment
Certificates
- Certified Eligibility Specialist (CES)
- Certified Benefits Professional (CBP)
- Certified Case Manager (CCM)
- Certified Aging Services Professional (CASP)
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How To Write Resume For Eligibility Services Representative
- Highlight your experience in processing high volumes of eligibility applications and ensuring compliance.
- Quantify your accomplishments with specific metrics, such as the number of applications processed or the percentage of accurate determinations.
- Demonstrate your knowledge of state and federal regulations and your ability to interpret and apply them.
- Emphasize your communication and interpersonal skills, as you will be interacting with applicants and other professionals.
- Showcase your ability to learn and adapt to changes in regulations and policies.
Essential Experience Highlights for a Strong Eligibility Services Representative Resume
- Processed over 1,200 eligibility applications per month, ensuring accuracy and compliance with state and federal regulations.
- Conducted comprehensive income and asset assessments to determine eligibility for various programs.
- Reviewed medical documentation and collaborated with healthcare professionals to verify eligibility for health insurance programs.
- Interviewed applicants, collected information, and made eligibility determinations for social services.
- Developed and implemented process improvements to streamline eligibility application processing.
- Provided exceptional customer service, effectively communicating with applicants and resolving inquiries promptly.
- Utilized case management software to track applications, manage caseloads, and ensure timely followups.
Frequently Asked Questions (FAQ’s) For Eligibility Services Representative
What are the primary responsibilities of an Eligibility Services Representative?
The primary responsibilities of an Eligibility Services Representative include processing eligibility applications, conducting income and asset assessments, verifying eligibility for various programs, interviewing applicants, and making eligibility determinations.
What qualifications are required to become an Eligibility Services Representative?
To become an Eligibility Services Representative, you typically need a high school diploma or equivalent, as well as experience in a related field, such as social work or healthcare. Some employers may prefer candidates with a bachelor’s degree in social work or a related field.
What are the key skills and abilities required for success as an Eligibility Services Representative?
Key skills and abilities for success as an Eligibility Services Representative include strong communication and interpersonal skills, the ability to interpret and apply regulations and policies, and proficiency in case management software.
What is the career outlook for Eligibility Services Representatives?
The career outlook for Eligibility Services Representatives is expected to be good over the next few years, as there is a growing demand for these professionals in healthcare, social services, and government agencies.
What is the average salary for an Eligibility Services Representative?
The average salary for an Eligibility Services Representative varies depending on experience, location, and employer. According to Indeed, the average salary for an Eligibility Services Representative in the United States is around $45,000 per year.
What are the benefits of working as an Eligibility Services Representative?
Benefits of working as an Eligibility Services Representative include the opportunity to help people in need, make a difference in their lives, and gain valuable experience in the healthcare or social services field.
What are the challenges of working as an Eligibility Services Representative?
Challenges of working as an Eligibility Services Representative include the need to be able to work independently and as part of a team, to be able to handle a high volume of work, and to be able to deal with difficult situations.
How can I prepare for an interview for an Eligibility Services Representative position?
To prepare for an interview for an Eligibility Services Representative position, you should research the organization and the position, practice answering common interview questions, and dress professionally.