Administrative Eligibility Hearing Officer

Tyeesha Jones

***********@*****.*** 646-***-****

PROFESSIONAL SUMMARY

Detailoriented administrative professional with extensive experience managing documentation, reviewing case records, and streamlining operational workflows well aligned with the responsibilities of an Eligibility Hearing Officer. Proficient in GSuite and complex database systems, with a strong ability to create, organize, and maintain accurate eligibility case files and supporting documentation. Skilled in ensuring procedural compliance, interpreting policy requirements, logging sensitive information, and managing timecritical tasks with precision. Developed internal GSuite infrastructures, including onboarding forms, policy templates, and automated scheduling tools, to improve efficiency and support highvolume intake environments. Recognized for clear, professional communication, strong customer service, and the ability to guide applicants, representatives, and stakeholders through multistep eligibility and review processes while maintaining confidentiality, fairness, and regulatory accuracy

CORE QUALIFICATIONS

Program & Operations Management

• Experienced administrative professional with strong expertise in program management, workflow optimization, and operational coordination within regulated environments.

Communication & Documentation

• Demonstrates exceptional written and verbal communication skills, producing clear, accurate documentation, reports, and case summaries for decision-making.

Strategic Performance & Relationship Building

• Proven ability to exceed expectations through strategic planning, collaborative problemsolving, and building effective working relationships with internal and external stakeholders.

Data Analysis & Compliance Support

• Skilled in conducting datadriven analysis to support case review, eligibility evaluations, procedural compliance, and evidencebased determinations.

Technical Systems Proficiency

• Proficient in GSuite and Microsoft Office Suite, with experience developing structured digital documentation, workflow tools, and organized filemanagement systems essential for case handling. Skilled in using Slack, Workday, IMS, and CareTracker/Optum to support case processing, communication, and operational efficiency across multiple administrative and compliance-driven environments.

Detail Orientation & Regulatory Accuracy

• Highly detailoriented, ensuring thorough review of case materials, precise documentation, and consistent adherence to legal standards and procedural requirements.

Professional Certifications

• Certified Notary Public supporting accurate verification of documents and strict confidentiality in handling sensitive case materials.

PROFESSIONAL EXPERIENCE

22nd Century Technologies – Virginia Department of Medical Assistance Services (DMAS)

Appeals Support Assistant July 2026

• Efficiently process and log all incoming Medicaid client and provider appeal requests into state compliance databases.

• Oversee automated filetimeline logging to ensure adherence to state and federal legal deadlines.

• Route complex legal inquiries and policy complaints to Hearing Officers, Operations Managers, or the Division Director as appropriate.

US Tech Solutions – Mondelez International

People Experience Advisor Aug 2025 – Jan 2026

• Applied Business Unit knowledge to deliver local HR services and support overall HR operations.

• Served as the primary point of contact for employee and manager HR questions, selfservice transactions, HR portal

navigation, policy interpretation, and process documentation.

• Delivered onboarding sessions, local learning modules, and timeandattendance training for diverse employee groups.

• Identified service gaps, recommended solutions, and assisted with implementing process improvements.

Adecco – Capital One

Leave Manager & HR Administrator (Hybrid Contract) Sep 2024 – Dec 2024

• Administered leave programs from initial request through returntowork, including eligibility review, medical certification collection, and intermittent/reducedschedule leave coordination.

• Maintained accurate, confidential employee FMLA files in compliance with federal regulations and company policy using Google Drive and Workday.

• Monitored and tracked FMLA leave usage through Google Sheets dashboards to ensure regulatory compliance.

• Applied ADA knowledge to support interactive accommodation processes and approval decisions.

• Collaborated with HR Directors, Administrators, and District Supervisors to facilitate leave coordination and timely resolutions.

• Led research and data analysis projects related to employee trends, compliance, and operational insights.

Reliable Tax Solutions

Compliance Administrator (Remote Contract) Jan 2023 – Jun 2024

• Provided technical and policy interpretation support to managers and staff.

• Advised department heads on compliance risk, standards, and best practices.

• Ensured strict confidentiality when handling sensitive personnel information.

• Conducted role evaluations and developed position descriptions aligned with business needs.

• Performed comprehensive analyses of registrations and insurance programs.

• Supported employee development and performance processes.

DISYS Global Staffing

Human Resources Coordinator Jul 2022 – Dec 2022

• Provided recruitment support including background checks, I9 compliance, registry notifications, and equipment issuance.

• Coordinated candidate communication to ensure timely interview scheduling and onboarding completion.

• Processed payroll for more than twenty employees and ensured accuracy of personnel files.

• Identified opportunities to improve document organization and administrative processes.

• Managed weekly staff meetings and prepared minutes for corporate records.

• Trained new employees on administrative procedures, company policies, and performance standards.

Harlem School of the Arts

Registration Director Nov 2013 – Mar 2018

• Managed daily registration operations and provided executive support to the CFO in reporting, projections, and tuitionrelated matters.

• Supervised a team of 25 spanning the bursar’s office, sales associates, front desk staff, and payroll administration.

• Reviewed audits and monitored financial and clientaccount reports.

• Facilitated communication between executives and frontline employees to support operational efficiency.

• Created performance and enrollment reports to support datadriven decisionmaking.

• Prepared pricing options for classes, workshops, and events, and generated reports reflecting attendance, client types, class rosters, and revenue.

EDUCATION

Metropolitan College of New York

•Master of Public Administration

College of New Rochelle

•Bachelor of Arts in Communication

Other Professional Experience:

•Motivational Speaker and Life Coach, Jan 2016 - Present.

•Plan and deliver motivational speeches for up to 3,000 attendees at a variety of conferences including graduation ceremonies, local charitable events, and women’s empowerment conferences.

•Motivate individuals to make positive life altering changes and assist in the execution of S.M.A.R.T. goals. Advises executives on best practices for employee growth and productivity goals thereby consistently contributing to employee retention.

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