Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Angela Carvajal

Bridgewater,NJ

Summary

Dynamic Entitlement Specialist at Elderserve Health Plan with a proven track record in ensuring Medicaid eligibility through expert problem-solving and meticulous documentation management. Skilled in conducting comprehensive application reviews and client interviews, I excel in resolving complex issues while fostering strong customer relations to enhance member satisfaction.

Overview

7
7
years of professional experience

Work History

Entitlement Specialist

Elderserve Health Plan
2019.07 - Current

Medicaid Maintenance & Renewals: Ensures continuous Medicaid eligibility for members by managing and submitting timely Medicaid recertifications (90-60 days prior to expiration).

Application Assistance: Completes new

Medicaid applications and RVI-3 (Resource

Verification Indicator) conversions.

Documentation & Record Keeping: Assists

members in gathering required financial and personal documentation and maintains

comprehensive records of all submitted

applications and renewals.

Field Visits & Outreach: Conducts in-home

visits to members to assist with the gathering of documents and to guide them through the renewal process

Issue Resolution: Acts as the primary point

of contact for resolving complex, problematic Medicaid issues, including working with the Office of Homecare Services to address denied claims.

Application Review and Processing:

Conduct comprehensive reviews of Medicaid applications, including financial records income, assets, and documentation to determine eligibility for coverage.

Client Interviews and Guidance: Interview

applicants or authorized representatives to

gather necessary information, explain

coverage options, and assist with the application process.

Education

No Degree - Liberal Arts

Hostos Community College
Bronx, NY

Skills

  • Customer relations
  • Expert problem solving
  • Analytical thinking
  • Documentation management

Languages

Spanish
Native or Bilingual

Timeline

Entitlement Specialist

Elderserve Health Plan
2019.07 - Current

No Degree - Liberal Arts

Hostos Community College