Work Type
Full TimeLocation Preference
RemoteHybridLocation: Orange, NJ
Open to relocation: No
Angela Carvajal
Orange,NJ
Work Preference
Summary
Detail-oriented entitlement specialist with extensive experience in Medicaid renewals and application processing. Recognized for strong problem-solving skills and the ability to navigate public assistance systems efficiently, ensuring timely support for clients.
Overview
1
1
Language
25
25
years of professional experience
Work History
Entitlement Specialist
Elderserve Homecare
Dayton, Ohio
07.2019 - Current
- Oversee timely completion of Medicaid renewals (recertifications 90-60 days prior to expiration), new applications, and Surplus and RVI-3 conversions.
- Tracked application and recertification progress using EPACES system, ensuring compliance with deadlines.
- Led resolution of complex eligibility issues, removed restriction codes, and coordinated with finance department to address denied claims.
- Assisted members in establishing Pooled Income Trusts, enabling them to meet financial criteria for Medicaid eligibility.
- Travel locally to members' homes to gather required verification documents and assist with paperwork.
Eligibility Specialist
Human Resources Administration
New York, New York
06.2016 - 08.2017
- Cross-referenced database referral data and matches using internal tracking systems, including Welfare Management System (WMS) and NYCWAY, to maintain accurate eligibility records.
- Calculated financial assistance amounts to support public assistance applicants, verified match material to identify overpayment amounts, and ensured correct budget management.
- Prepared electronic and paper eligibility forms while managing weekly caseloads, initiating actions for benefits adjustments, recoupment, or closures to ensure timely processing.
- Complete daily activity reports and meet regularly with supervisor to review findings and workflow execution.
Eligibility Specialist
Human Resources Administration
New York , New York
07.2001 - 06.2016
- Collected and reviewed financial, residency, and medical documentation to ensure accurate submission or recertification of New York Medicaid cases.
- Complete required case action utilizing the Welfare Management System (WMS) and Various external program applications, such as the Eligibility Data Image Transfer System (EDITS) plus, the HRA One Viewer and eMedNY and complete notices, forms, and system updates.
- Assessed need for additional documentation or referrals to outside agencies to support informed eligibility decisions.
- Collaborated with Unit Supervisor to resolve complex issues and expedite case completion within strict deadlines.
Education
Some College (No Degree) - Liberal Arts
Hostos Community College
Bronx, NYSkills
- Eligibility determination
- Medicaid regulations
- Application processing
- Document verification
- Financial analysis
- Public assistance systems
Languages
Spanish
Native/ Bilingual
Timeline
Entitlement Specialist
Elderserve Homecare
07.2019 - Current
Eligibility Specialist
Human Resources Administration
06.2016 - 08.2017
Eligibility Specialist
Human Resources Administration
07.2001 - 06.2016
Some College (No Degree) - Liberal Arts
Hostos Community College