Angela Cole

Explain and interpret eligibility criteria and requirements for public assistance programs.
Collect customer data and determine eligibility based on policy.
Discuss customer goals and participation levels.
Helps a client assess their skills and evaluate their ability to obtain and retain employment.
Makes the appropriate referrals to other DHS programs, state services or local private services to verify the individual receives all available benefits.
Complete case documentation, respond to electronic correspondence, and make entries into automated computer systems.
Communicate with customers and other Department of Human Services (DHS) staff in both verbal and written form, including out of state contacts.
Perform these functions as part of an assigned caseload and on a rotational basis.

Determine initial eligibility of the applicants in the areas of Aid to the Aged, Blind, and Disabled (AABD).

Review all automated intake systems, inquiries and confirm verifications of all collected information. Utilized a variety of computer system to process cases such as IES, MMIS, LTC, and CRM. Reviewed difficult and complex cases to determine benefit eligibility.

Apply strong understanding of policy and procedures to process Approvals and Denials during the Public Health Emergency/COVID 19 policy and processed Admissions for applicants needing Long Term Care.

Perform detailed budget computations.

Notify applicants, power of attorneys, approved representatives, nursing homes, and or supportive living facilities of changes in status and appeal rights.

Utilize current policy to perform routine clearings to verify applicant eligibility. Update data pertaining to assigned caseloads by completing and filling out all agency forms to ensure that documents are uploaded in applicant's ECR case accurately.

Made appropriate entries in case records of all actions taken, respond to routine inquiries from all parties involved and maintain phone contact or initiate correspondence to determine changes in applicant's status.

Assist coworkers with the processing of claims, understanding eligibility as well as with admissions and policies. Maintain daily Logs of all work performed on a weekly basis for assigned managers.

Prepared reports to provide responses to specific problems.

Entered confidential patient information and updated electronic records in database.

Liaised with healthcare facility personnel, insurance representatives, physicians and vendors for smooth communication.

Contacted patients to confirm or reschedule appointments to minimize no-show appointments.

Reviewed demographic, clinical and insurance information before sending to referred specialists.

Obtained PA for services such as diagnostic imaging.

Collected required signatures to initiate referral process.

Identified and resolved inconsistencies in patient responses by means of appropriate questioning or explanation.

Managed and obtained insurance authorizations for patient referrals from physicians.

Scheduled patients according to availability, urgency and insurance authorization guidelines.

Reviewed data obtained from referring physicians for completeness and accuracy.

Gathered and verified insurance requirements to meet payer requirements.

Reviewed referral details and expectations with providers and patients and requested new referrals when necessary.

Prepared reports to provide responses to specific problems.

Collected and analyzed referral data and tallied number of referrals.

Entered confidential patient information and updated electronic records in database.

Aided clinical team to support administrative needs for clinical referrals.

Contacted patients to confirm or reschedule appointments to minimize no-show appointments.

Reviewed demographic, clinical and insurance information before sending to referred specialists.

Obtained PA for services such as diagnostic imaging.

Identified and resolved inconsistencies in patient responses by means of appropriate questioning or explanation.

Collected required signatures to initiate referral process.

Scheduled patients according to availability, urgency and insurance authorization guidelines.

Managed and obtained insurance authorizations for patient referrals from physicians.

Developed productive working relationships with numerous insurance company representatives.

Gathered and verified insurance requirements to meet payer requirements.

Verified document authenticity to process license application.

Recorded vital and fiscal records and accounts.

Verified application data and account information against legal documentation to determine accuracy and integrity.

Received and submitted payments for fees and fines, accurately tracking amounts, issuing receipts and updating computer systems.

Prepared lists of overdue accounts, license suspensions and issuances.

Investigated past and current licensees to perform record checks.

Evaluated applications and assessment results to determine eligibility and acceptance.

Assembled photographs with printed license information to produce completed documents.

Entered customer information and updates in database system to track leads, interactions, relationships and propel sales opportunities.

Scheduled and arranged travel and hotel reservations for meetings, conferences and seminars.

Opened, read and replied to e-mails, letters and correspondence on behalf of executives.

Managed daily invoices, reports and proposals.

Coordinated meeting and work schedules for staff teams and executives.

Revised and maintained master calendar to coordinate meetings across multiple time zones.

Tackled and addressed top-level, high-priority issues with professional administrative discretion.

Maintained company confidence and protected business operations by keeping sensitive information confidential.

Handled variety of organizational and administrative duties, anticipating needs of executives and always being two steps ahead.

Set up meeting and event logistics for senior management and updated calendars.

Managed and tracked expenses to meet company budget requirements.

Released information to persons or agencies according to regulations.

Proofread documents carefully to check accuracy and completeness of all paperwork.

Entered patient insurance, demographic and health information into software and confirmed records.

Set up patient charts and documented information in various company software.

Answered questions and fulfilled requests with friendly and knowledgeable service.

Processed patient admission and discharge documents.

Located and retrieved files, assisting public with general information.

Safeguarded medical records to maintain patient confidentiality.

Transmitted information or documents to customers through email, mailings or facsimile machine.

Completed thorough opening, closing and shift change functions to maintain operational standards each day.

Orchestrated staff meetings to maintain open communication and quickly address concerns.

Reviewed completed work to verify consistency, quality and conformance.

Researched coverage and premium options and supplied clients with best coverage available for individual needs.

Sorted and distributed incoming faxes, letters and emails for office distribution.

Pleasantly welcomed visitors, answered phone calls and maintained front reception desk.

Filed and submitted insurance claims.

Coordinated travel arrangements and completed expense reports for travel reimbursement.

Handled incoming calls and directed callers to appropriate department or employee.

Responded to customer issues to provide immediate resolution and improve retention.

Kept office equipment functional and supplies well-stocked to promote efficient operations.