Andrea Deyerle
Salem,VA
Summary
Skilled Medicaid Eligibility Specialist with a proven track record at Roanoke County Department of Social Services, enhancing client service quality through expert knowledge of government programs and exceptional customer service. Demonstrated ability in documentation and interpersonal communication, significantly improving efficiency and client satisfaction. Excelled in team collaboration and problem-solving, ensuring compliance and accuracy in eligibility determinations.
Overview
17
17
years of professional experience
Work History
Medicaid Eligibility Specialist
Roanoke County Department of Social Services
Salem, VA
08.2017 - Current
- Completed initial assessments to determine eligibility for Medicaid Long Term Care and Auxiliary Grants.
- Perform assessments to ensure compliance with state and federal eligibility criteria, encompassing both financial and non-financial aspects.
- Researched discrepancies between submitted forms and available records to ensure compliance with regulations.
- Established relationships with community organizations that provide assistance in obtaining health care services for low-income families.
- Verified accuracy of applicant's financial information against third-party sources such as employers, banks or government agencies.
- Investigated complaints regarding eligibility determinations or denials.
- Attended training sessions, seminars and workshops related to Medicaid programs.
- Maintained up-to-date knowledge of state and federal regulations pertaining to Medicaid eligibility.
- Evaluated appeals of denied applications using established criteria.
- Processed requests for changes in existing Medicaid cases.
- Assisted individuals with the completion of complex paperwork related to their application process.
- Identified areas where improvements could be made in order improve efficiency or customer service levels.
- Compiled and documented information regarding applicant's income, assets, insurance coverage and other relevant data.
- Maintained accurate and up-to-date information in case management systems.
- Collaborated with other departments within the organization in order to resolve issues relating to Medicaid eligibility requirements.
- Advised clients on how best to utilize available resources in order to meet their needs.
- Reviewed applications and supporting documents to determine applicant's eligibility for Medicaid benefits.
- Efficiently managed queries regarding Medicaid services from a diverse group of individuals including applicants and providers.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
- Informed applicants of other agencies providing useful or related assistance.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Maintained positive working relationship with fellow staff and management.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Actively listened to clients' concerns and worked collaboratively with them to identify solutions.
Benefit Program Specialist
Fredricksburg Department of Social Services
Fredericksburg, Virginia
08.2013 - 08.2017
- Processed applications for benefits programs SNAP, Medicaid, and Energy Assistance.
- Maintained accurate records of participant's enrollment in benefits programs.
- Monitored compliance with state and federal regulations governing benefit programs.
- Prepared benefit forms and documents for processing.
- Identified potential fraud cases involving misuse of benefits programs funds.
- Generated reports summarizing benefit program activity and outcomes.
- Reviewed existing policies and procedures related to benefits programs, making recommendations as needed.
- Researched and responded to inquiries from the public regarding benefit program policies and procedures.
- Assessed eligibility of participants for benefits programs based on income, resources and other criteria.
- Collaborated with external agencies in order to coordinate services provided through multiple agencies.
- Provided assistance with completing paperwork required for application process.
- Coordinated with other departments to ensure accuracy of information related to benefits programs.
- Analyzed data related to benefit program utilization trends.
- Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.
- Checked accuracy and completeness of benefits applications and documents.
Medicaid Eligibility Specialist
Pulaski County Department of Social Services
Pulaski, VA
06.2008 - 07.2013
- Applied comprehensive knowledge of policies to assess SNAP and Medicaid qualifications.
- Researched discrepancies between application information and other sources of data to determine the correct eligibility determination.
- Responded timely to inquiries from clients regarding their SNAP and Medicaid applications. .
- Processed renewal forms, changes in household composition, medical coverage or financial status as required by law.
- Collaborated with team members to enhance client, customer service quality.
- Assisted applicants with the completion of their applications when needed.
- Verified income, assets, and other resources in accordance with federal and state regulations.
- Maintained confidential case records according to established policies and procedures.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Maintained positive working relationship with fellow staff and management.
Education
Some College (No Degree) - Social Work
Roanoke Higher Education Center
Roanoke, VASome College (No Degree) - Social Work
New River Community College
Roanoke, VASkills
- Long Term Care
- Auxiliary Grant
- Medicaid
- Medicare Program Understanding
- Customer service
- Documentation skills
- Interpersonal communication
- Interviewing techniques
- Self motivation
- Client advocacy
- Problem-solving abilities
- Teamwork and collaboration
- Experience with Microsoft Office programs
- Analytical skills
- Time management abilities
References
References available upon request.
Timeline
Medicaid Eligibility Specialist
Roanoke County Department of Social Services
08.2017 - Current
Benefit Program Specialist
Fredricksburg Department of Social Services
08.2013 - 08.2017
Medicaid Eligibility Specialist
Pulaski County Department of Social Services
06.2008 - 07.2013
Some College (No Degree) - Social Work
Roanoke Higher Education Center
Some College (No Degree) - Social Work
New River Community College
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