Results-oriented professional with extensive experience in eligibility determination and client assessment. Proven track record of accurately processing applications and maintaining compliance with policies. Known for collaborative efforts, reliability, and adaptability in dynamic settings.
Overview
21
21
years of professional experience
Work History
Eligibility Specialist, Authorization Specialist
Netsmart Technologies Inc.
01.2024 - 01.2025
Reviewed eligibility applications to determine compliance with policy requirements.
Assisted clients in understanding eligibility criteria and application processes.
Updated records in case management systems to ensure accurate information tracking.
Identified process gaps and recommended improvements to streamline operations.
Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
Call Center Representative, Eligibility Specialist
Vital Caring Home Health and Hospice
01.2020 - 01.2024
Reviewed and processed eligibility applications to ensure compliance with regulations.
Assisted clients in understanding program requirements and application procedures.
Conducted thorough interviews to gather necessary information for eligibility determination.
Maintained accurate records of client interactions and application statuses in database systems.
Collaborated with team members to improve workflow efficiency and service delivery.
Provided training support to new staff on eligibility assessment processes and tools.
Analyzed data trends to identify areas for process improvement within the eligibility framework.
Customer Service Representative
Sawyer Metal
01.2011 - 01.2019
Assisted customers with inquiries, ensuring prompt and accurate responses.
Resolved customer complaints effectively, enhancing satisfaction and loyalty.
Processed orders efficiently, maintaining accuracy in data entry and order fulfillment.
Utilized CRM software to track customer interactions and manage follow-ups.
Monitored inventory levels, coordinating with suppliers to ensure timely restocking.
Trained new staff on company policies and customer service protocols.
Provided product knowledge support to customers, facilitating informed purchasing decisions.
Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Customer Service Representative
Check N’ Go
01.2009 - 01.2011
Beauty Advisor, Cashier, Photo Technician
Walgreens
01.2004 - 01.2009
Education
Bachelors of liberal arts - Criminal Justice Law Enforcement
Stephen F. Austin State University
Nacogdoches, Texas
05.2010
Skills
Telephone etiquette
Confidentiality
Customer service
Teamwork and collaboration
Problem-solving abilities
Self motivation
Effective communication skills
Documentation and reporting
Policy interpretation
Knowledgeable in Microsoft Office
Timeline
Eligibility Specialist, Authorization Specialist
Netsmart Technologies Inc.
01.2024 - 01.2025
Call Center Representative, Eligibility Specialist
Vital Caring Home Health and Hospice
01.2020 - 01.2024
Customer Service Representative
Sawyer Metal
01.2011 - 01.2019
Customer Service Representative
Check N’ Go
01.2009 - 01.2011
Beauty Advisor, Cashier, Photo Technician
Walgreens
01.2004 - 01.2009
Bachelors of liberal arts - Criminal Justice Law Enforcement