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Customer Service Eligibility Specialist

Location:
Milwaukee, WI
Posted:
October 23, 2022

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Resume:

BACKGROUND SUMMARY

I worked in the health care service field collecting information and advocating in assisting clients with their eligibility of Medicaid and Medicare insurances. Directing clients to the available programs that help clients live a viable life. I have the ability to relate effectively to a variety of target populations with strong written and verbal communications skills.

EDUCATION

Milwaukee Area Technical College 1985 1987

Computerized accounting job training program.

North Division High school 1971 1975

Diploma

SKILLS & ABILITIES

Customer Service

The ability to obtain information using available resources to provide accurate information as needed, and communicating information in the form of written and/or verbal communications.

Customer service oriented with interpersonal skill and phone etiquette.

Effectively communicates information to internal and external while maintaining a focus on customer service and client confidentiality.

Organized / Accurate

The ability to manage multiple priorities with timeliness and deliver with a high degree of accuracy by being attentive to details and organizing according to priority.

Obtain complete demographic information and accurately schedule accordingly

Work independently in a fast environment with constant interruptions

Training / Interviewing

Trained consultants on jobs responsibilities and procedures. Also interview perspective participants to insure eligibility.

Computer knowledge

Microsoft Word, Outlook, Microsoft Excel, Great Plains dbase, Microsoft Access,

VOLUNTEER SERVICE

Brown Deer Elementary Bryant Elementary

Cafeteria Helper Tutoring

EXPERIENCE

Seton- Northwest Catholic School Milwaukee, WI

Food Service Lead

August 28, 2021- Present

Hands-on experience in preparing meals according to standard nutritious recipes

Thorough understanding of undertaking procedures to maintain hygienic conditions while preparing and serving food

Provided professional, friendly and engaging service to ensure a positive experience during lunch hours

Promptly handled cafeteria issues and complaints or concerns

Aramark – Wilson Elementary School Mequon, WI

Food Handler

August 2017 to June 2018

Hands-on experience in preparing meals according to standard nutritious recipes

Thorough understanding of undertaking procedures to maintain hygienic conditions while preparing and serving food

Provided professional, friendly and engaging service to ensure a positive experience during lunch hours

Promptly handled cafeteria issues and complaints or concerns

Family care/ Anew Self Direct Brown Deer, WI

Caregiver

2013 to April 10, 2017

Assisting with daily personal needs such as dietary and grooming.

Manage all financial and nonfinancial issues.

Instruct physical and mental exercises prescribed by doctor.

Administrate scheduled daily medicines.

Schedule and transport to necessary appointments.

The Management Group Madison, WI

Iris Consultant

2010 to 2013

Created and implement a self directed Life Plans.

Oversaw participants in adhering to IRIS program policies and procedures.

Provided training and resource for other Iris consultants.

Scheduled monthly face to face meeting with participants to insure continue participations.

Ability to relate effectively to the participant in a professional and courteous manner

Maintaining customer service and participant confidentiality.

Obtain complete demographic information and accurately schedule appointments.

Community Care Organization Milwaukee, WI

Financial Eligibility Specialist

1986 to 2009

Facilitate the initial and ongoing certification of Medicaid enrollment.

Register clients, obtaining and entering all necessary demographic and financial related information needed

Maintained and managed caseloads of more than 425 clients.

Knowledge and experience in different insurance coverage

Conducted and followed complex written rules and regulations from the Federal, State, and local laws relating to Medicaid and Medicare.

Customer service oriented with strong interpersonal skills and phone etiquette

Created clear and concise reports for the accumulation, transmission and dissemination of capitates clients or other staff member and agencies

Liaison between government agencies (i.e. Social Security Administration, Milwaukee County, and the State of Wisconsin).

Developed and maintained documentation of procedures for the Financial Eligibility functions

Work independently with the ability to be professional and courteous manner

Community Care Organization

Accounting Assistant

Verified and processed invoices for direct services for four programs under the Community Care umbrella.

Processed the payroll biweekly, including tax and IRA deposits.

Conducted reimbursement process to Electronic Data System.

Entered data on dbase and Great Plains computer software.

Made deposits to main bank account and maintain the checkbook register.

Performed account reconciliation.

Followed up on denied claims, and enter journal entries into the General Ledger.

Handled inquiries from service providers, clients, and department correspondence.

Maintained and organized filing systems of all invoices, supporting documentation.



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