Customer Service Eligibility Specialist
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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