Ana Lilia Rosas

Reviewed applications for eligibility and determined whether applicants met the criteria to receive benefits.
Maintained comprehensive knowledge of program regulations, policies,and procedures.
Conducted detailed interviews with applicants to determine their
eligibility for assistance programs.
Processed client applications in accordance with established guidelines.
Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
Participated in community events related to social services outreach initiatives.
Maintained confidential patient documentation to prevent data
compromise and comply with HIPAA regulations.

Accurately performs all data in the claims system, initiating the claims handling process.
Answer customer questions and provide information when possible, and direct requests to the appropriate departments, as necessary.
Accept and manage new update knowledge to policies when filing claims

Answer's customer calls and provide callers with informed and objective responses to complex or escalated concerns regarding social services eligibility requirements, enrollment, and programs.
Perform in-depth research utilizing TIERS and TW/MEP Handbooks for policy-specific.
Retrieves, researches, and analyzes data from multiple databases to answer client concerns.

Accurately performs all data entry functions to reflect and document client activity/transactions, and performs other duties as may be assigned by management.
Manages and updates required spreadsheets for proper tracking and reporting of case issues, reviews available updates to Knowledge Sources and email as pertains to job functions.
Accepts new knowledge of policy and procedures concerning state programs and integrates it with resource materials to answer client concerns.
Maintain quality assurance (QA) scores about 90%, meeting all KPR's including AHT, Not Ready Time, Calls Handled, Hold Time, etc.