Detail-Oriented Eligibility Advisor experienced in application evaluation and compliance review. Enhanced client understanding of complex eligibility processes and ensured adherence to state regulations through effective communication. Improved service delivery and streamlined application processes by leveraging expertise in eligibility determination and fraud investigation.
Overview
9
9
years of professional experience
Work History
Eligibility Advisor
Texas Health and Human Services Commission
Grand Prairie, Texas
08.2024 - Current
Evaluated applications for eligibility in health and human services programs.
Guided clients in navigating eligibility requirements and application processes to enhance understanding and compliance.
Reviewed documentation to ensure compliance with state regulations and policies.
Communicated effectively with clients via phone and in-person consultations.
Collaborated with team members to optimize application processing procedures, improving overall workflow.
Researched policy changes impacting eligibility criteria for various programs.
Verified client information and resolved discrepancies in applications to ensure accuracy and compliance.
Demonstrated expertise in SNAP, Medicaid, and CHIP programs.
Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
Fraud Analyst
Bread Financial
Atlanta, California
12.2020 - 07.2024
Analyzed transaction data to identify potential fraudulent activities.
Investigated and resolved customer disputes related to fraud claims.
Collaborated with cross-functional teams to enhance fraud detection processes.
Monitored alerts from fraud detection systems for suspicious behavior.
Educated customers on best practices to prevent fraud incidents.
Reviewed customer profiles for any changes that may indicate fraudulent activities.
Customer Service Representative
Anchor Energy
Dallas, Texas
01.2018 - 10.2020
Resolved customer complaints through effective communication and problem-solving techniques.
Maintained a positive relationship with customers by delivering exceptional service consistently.
Assisted customers with inquiries regarding energy services and account management.
Answered customer inquiries and provided accurate information regarding products and services.
Managed billing inquiries and provided accurate information on account status.
Documented customer interactions in the company database for future reference.
Collaborated with team members to improve customer service processes and efficiency.
Eligibility Advisor II at Texas Department of Health and Human Services CommissionEligibility Advisor II at Texas Department of Health and Human Services Commission
Appeals and Mitigation Eligibility Advisor III at State of Texas Health and Human Service CommissionAppeals and Mitigation Eligibility Advisor III at State of Texas Health and Human Service Commission