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Royce Lewis
Eligibility Technician
Summary
Highly skilled and experienced Eligibility Technician with a proven track record of processing over 2,000 applications per month. Possesses a deep understanding of complex eligibility criteria, medical terminology, and ICD-10 and CPT coding. Expertise in reviewing financial documents, conducting comprehensive interviews, and verifying information to ensure accurate and timely eligibility determinations. Collaborates effectively with healthcare providers and social service agencies to obtain additional information and coordinate care. Proficient in using eligibility software and databases to perform eligibility checks and maintain accurate records. Committed to providing clear and timely explanations of eligibility decisions to clients and stakeholders.
Education
Associate’s Degree
November 2015
Skills
- Medical Terminology
- Pharmacology
- Diagnosis and Treatment Codes
- ICD-10 and CPT Coding
- Eligibility Verification
- Patient Registration
Work Experience
Eligibility Technician
- Identified and resolved discrepancies in application information, preventing errors and ensuring timely processing.
- Collaborated with healthcare providers and social service agencies to obtain additional information and coordinate care.
- Utilized eligibility software and databases to perform eligibility checks and maintain accurate records.
- Provided clear and timely explanations of eligibility decisions to clients and stakeholders.
Eligibility Technician
- Processed over 2,000 applications per month, ensuring accuracy and completeness of eligibility determinations.
- Reviewed and interpreted complex eligibility criteria and guidelines, applying them consistently to various cases.
- Conducted comprehensive interviews to gather necessary information and determine client eligibility.
- Verified and analyzed financial documents, such as tax returns, pay stubs, and bank statements.
Accomplishments
- Successfully processed and verified over 1,000 eligibility applications within a tight turnaround time, ensuring timely access to benefits for eligible individuals.
- Developed and implemented a streamlined verification process that reduced processing time by 20%, improving efficiency and customer satisfaction.
- Collaborated with crossfunctional teams to improve data quality and communication, ensuring the accuracy and efficiency of eligibility determinations.
- Trained and mentored new staff members, effectively transferring knowledge and ensuring the continuity of eligibility services.
- Implemented best practices in data security and privacy to protect sensitive customer information, ensuring compliance with regulatory standards.
Awards
- Received the Employee of the Quarter award for exceptional performance and dedication to the Eligibility Technician role.
- Recognized for consistently achieving an accuracy rate of 99.5% in eligibility determinations, minimizing errors and ensuring accurate disbursements.
- Received the Innovation Award for developing a tool that automated eligibility calculations, saving staff hours and increasing productivity.
- Recognized for exceptional customer service skills, consistently providing clear and helpful guidance to customers during the eligibility process.
Certificates
- Certified Eligibility Specialist (CES)
- Certified Patient Access Representative (CPAR)
- Certified Health Insurance Specialist (CHIS)
- Certified Coding Associate (CCA)
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How To Write Resume For Eligibility Technician
- Highlight your experience in processing a high volume of applications and your ability to meet deadlines.
- Demonstrate your knowledge of eligibility criteria and guidelines, as well as your ability to apply them consistently.
- Showcase your skills in conducting interviews and gathering accurate information from clients.
- Emphasize your ability to identify and resolve discrepancies in application information.
- Highlight your experience in collaborating with healthcare providers and social service agencies.
- Showcase your proficiency in using eligibility software and databases.
Essential Experience Highlights for a Strong Eligibility Technician Resume
- Processed over 2,000 applications per month, ensuring accuracy and completeness of eligibility determinations.
- Reviewed and interpreted complex eligibility criteria and guidelines, applying them consistently to various cases.
- Conducted comprehensive interviews to gather necessary information and determine client eligibility.
- Verified and analyzed financial documents, such as tax returns, pay stubs, and bank statements.
- Identified and resolved discrepancies in application information, preventing errors and ensuring timely processing.
- Collaborated with healthcare providers and social service agencies to obtain additional information and coordinate care.
- Utilized eligibility software and databases to perform eligibility checks and maintain accurate records.
- Provided clear and timely explanations of eligibility decisions to clients and stakeholders.
Frequently Asked Questions (FAQ’s) For Eligibility Technician
What is the role of an Eligibility Technician?
An Eligibility Technician determines whether individuals or families qualify for health insurance or other government assistance programs based on their income, assets, and other factors.
What are the qualifications for an Eligibility Technician?
Typically, an Eligibility Technician needs a high school diploma or equivalent, as well as experience in customer service or healthcare. Some employers may prefer candidates with a college degree or certification in health insurance.
What are the key skills for an Eligibility Technician?
An Eligibility Technician should have excellent communication and interpersonal skills, as well as the ability to work independently and as part of a team. They should also be proficient in using computers and software, and have a strong understanding of medical terminology and billing codes.
What is the career outlook for an Eligibility Technician?
The job outlook for Eligibility Technicians is expected to grow faster than average in the coming years, due to the increasing demand for healthcare services and the aging population.
What is the average salary for an Eligibility Technician?
The average salary for an Eligibility Technician varies depending on their experience, location, and employer. According to the U.S. Bureau of Labor Statistics, the median annual salary for Eligibility Technicians was $37,630 in May 2021.