Medicaid Eligibility Specialist with Helpdesk Expertise

Yolanda Burgess

* ****** *****, ********, ***** Carolina 29204

************@*****.*** / 803-***-****

OBJECTIVE

Detail oriented, experienced, and knowledgeable Medicaid Eligibility Support Specialist currently serving as SME and previously Tier 1 Helpdesk Support in a remote environment to ensure participants receive eligible benefits while providing top notch customer service.

SKILLS AND COMPETENCIES

Strong data entry with attention to detail Communication MMIS; Curam Research and development Case Management OnBase; CRM Adaptability Microsoft Office MS Teams

Problem solving Sharepoint One Note

EMPLOYMENT HISTORY

North Highland / Pacer Staffing (Remote)Columbia, SC Eligibility Support Specialist 9/2023-Present

Review and assess participant eligibility for SC Medicaid benefits while adhering to policy guidelines.

Taskforce Team member with 85% Tier 1 HelpDesk resolution without requiring additional escalation.

Provide accurate processing of Medicaid applications and Annual Review with 90-100% efficiency.

Conducted small groups and individual training sessions with Team members.

Provide expert level support with complex Medicaid eligibility cases.

Provide expert interpretation and translation of processing based on State Policies and Medicaid requirements.

Analyze and troubleshoot processing issues affecting participant eligibility. Columbia Housing Authority Columbia, SC

Transaction Clerk/Customer Service 7/2022-7/2023

Managed clerical and administrative functions of housing transactions.

Reviewed Annual Recertification applications for accuracy and completeness.

Respond to tenant inquiries regarding billing, payments, and general housing program policies.

Collaborated closely with Housing Authority staff, property managers, and leasing offices.

Managed tenant files to ensure accuracy and successfully passed State audit.

Communicated professionally and provided exceptional customer service to tenants Concentrix (Remote)Columbia, SC

Customer Service Representative 6/2020-9/2021

Scheduled patient appointment during COVID-19; provided test results and responded to various inquiries.

Provided prior-authorization and formulary medication assistance; documented activities in CRM.

Escalated urgent matters to the Supervisory Team.

Communicated with external medical professionals regarding patient inquiries and prescriptions. Education & Recognition

Burke High School, Charleston, SC-Graduated: June 1987

Recognition for High Achievement- North Highland / Concentrix

Notary Public-Richland County, Commission Expires 6/2033

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